This article is more than 5 years old. Information may no longer be current.
Lauge Hansen classification helps diagnose pronation-abduction, pronation-eversion ankle fractures
Click Here to Manage Email Alerts
Hans Zwipp
Pronation-abduction and eversion fractures, as well as new ankle fracture diagnosis and treatment techniques, will be among the topics discussed during an instructional lecture scheduled for this year’s EFORT Congress, according to Hans Zwipp, MD, chairman of the Trauma Department at Carl Gustav Carus University Hospital in Dresden, Germany, who is scheduled to give the main lecture in the session.
The course, which will address fractures within the Lauge Hansen classification, including pronation-abduction, pronation-eversion, supination-adduction and supination-eversion-type ankle injuries, will be moderated by Jean-Christophe Bel, MD, of Lyon, France.
Zwipp noted in a recent interview that he will inform residents how to properly diagnose and treat ankle fractures, specifically pronation-abduction and pronation-eversion fractures.
“I would recommend watching pronation-abduction fractures more precisely, which should be treated as an emergency case,” he told Orthopaedics Today Europe.
“If you have a pronation-eversion fracture, especially a Messina [type fracture], you always have to revise the syndesmotic area. You have to bring back the fibula in length. You have to use a big clamp which runs from tip to tip on the medial and lateral side just to push the fibula in the right position in the fibularis tibiae incision and then use always two syndesmotic screws for the Messina fractures,” Zwipp said.
In his lecture, Zwipp will also suggest using more preoperative and postoperative CT scans, as well as intraoperative 3-D fluoroscopy whenever syndesmotic screws are used for pronation-abduction fractures. Attendees also will learn how to treat osteoporotic and osteopenic pronation-abduction fractures, as they have become more common, he noted.
“The most unstable fracture is the pronation-abduction fracture and especially in the elderly patients we will treat this as an emergency case and we will do — if we can — immediate open reduction internal fixation (ORIF) or if the swelling is too critical, we will do some tibial tarsal transfixation and then in the second step we will do CT scanning and an ORIF after the swelling has come down,” Zwipp said.
Zwipp said attendees may find it a beneficial refresher session as the techniques taught years ago may be outdated due to recent changes in the age of patients and the types of fractures treated.
“We have to deal more and more with osteoporotic fractures and we [frequently] see real problems — even after ORIF — with chronic instability, with malalignment, with shortening of the fibula, so not everyone is updated with the best quality diagnostics and treatment,” Zwipp said. – by Jeff Craven
Reference:For more information:
- Zwipp H. Instructional lecture: ankle fractures. Scheduled to be presented May 25, 8:00-9:00, at the 13th EFORT Congress 2012, May 23-25. Berlin.
- Hans Zwipp, MD, can be reached at Fetscherstraße 74, 01307 Dresden, Germany; +49-351-458-3777; email: hans.zwipp@uniklinikum-dresden.de.
- Disclosure: Zwipp has no relevant financial disclosures.