Ankle Fractures

Ankle Fractures, radiograph of a bimalleolar ankle fracture
Radiograph of a bimalleolar ankle fracture. Image by Article authors: Nazzar Tellisi, I S Abdulkareem, P G Giannoudis, Wikimedia Commons, CC BY 4.0.

Classification

Lauge-Hansen

(Position of foot/ direction of deforming force)

MechanismStageInjury
Supination adductionIRupture or avulsion of the lateral collateral ligament
IIVertical medial malleolus fracture
Supination external rotationIAnterior tibiofibular ligament rupture
IISpiral fibular fracture
IIIPosterior malleolus fracture or posterior tibiofibular ligament rupture
IVMedial malleolus fracture
Pronation abductionIMedial malleolus avulsion fracture
IISyndesmosis rupture
IIIFibular fracture above the syndesmosis
Pronation external rotationIMedial malleolus avulsion fracture or deltoid rupture
IIAnterior tibiofibular ligament and interosseous membrane rupture
IIIHigh fibular fracture
IVPosterolateral malleolus fracture or posterior tibiofibular ligament rupture

Original publication Lauge-Hansen N. Fractures of the ankle. II. Combined experimental-surgical and experimental-roentgenologic investigations. Arch Surg (1920). 1950;60(5):957-85.

Danis-Weber

TypeFibular fracture level
ABelow the syndesmosis
BAt the syndesmosis
CAbove the syndesmosis

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.