In Supination- external rotation fxs of the ankle as described by Lauge Hansen the second stage, (after antirior inferio-tibiofibular injury) the fibular fx also called as “mixed oblique fx starts at the tibial pilon level and travells up in a spiral manner leaving the introseus tibio-fibular ligament intact. Since the antirior TF ligament is torn but the stroger IO ligament is intact, this type of Fx of the fibula is called ‘Mixed Oblique Fx”.
If the fibular fx is above the syndemotic level it is Pronation-External rotation Stage 3,where syndesmosis is completly disrupted and is not a Supination injury, as you have staed.
This is very important differenccation as a trans-syndesmotic screw is indicared in Pronation Exteral rotation injuries and not in Spination lesions as the syndesmosis is stable once the fibular fx is fixed usally with a plate.
You can find the Original Article by Lauge Hansen in Archives of Surgery published about 60 years ago! He describes full effects of the position of the foot ( Supination or Pronation)on the nature of ankle lesions in detail in 4 articles.
In Supination- external rotation fxs of the ankle as described by Lauge Hansen the second stage, (after antirior inferio-tibiofibular injury) the fibular fx also called as “mixed oblique fx starts at the tibial pilon level and travells up in a spiral manner leaving the introseus tibio-fibular ligament intact. Since the antirior TF ligament is torn but the stroger IO ligament is intact, this type of Fx of the fibula is called ‘Mixed Oblique Fx”.
If the fibular fx is above the syndemotic level it is Pronation-External rotation Stage 3,where syndesmosis is completly disrupted and is not a Supination injury, as you have staed.
This is very important differenccation as a trans-syndesmotic screw is indicared in Pronation Exteral rotation injuries and not in Spination lesions as the syndesmosis is stable once the fibular fx is fixed usally with a plate.
You can find the Original Article by Lauge Hansen in Archives of Surgery published about 60 years ago! He describes full effects of the position of the foot ( Supination or Pronation)on the nature of ankle lesions in detail in 4 articles.
Thank you for your good comments..