The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
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Associations between Weber C ankle fractures and pronation external rotation (PER) injuries of the Lauge-Hansen classification have often been incorrectly correlated. The purpose of the present study was to evaluate the Lauge-Hansen designation of Weber C fractures by establishing the proportion of Weber C fractures that are supination external rotation (SER), supination adduction (SA), pronation abduction (PA), PER, and hyperplantarflexion variant fractures. A clinical database of operative ankle fractures treated by the senior author (D. ⋯ Our study quantitatively demonstrated that not all Weber C fractures occur secondary to pronation injuries. This distinction is important, because all pronation injuries will demonstrate medial ankle injury, but SER and variant fractures might not. We therefore recommend careful evaluation of the fibular fracture characteristics, including the direction of fracture propagation and the distance from the tibial plafond, when classifying Weber C fractures using the Lauge-Hansen system, because correct classification is vital in preparation for appropriate operative treatment.
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A fracture of the lateral margin of the distal tibia has commonly been called a Tillaux fracture, which is an avulsion-type fracture that can result from the pull of the anterior inferior tibiofibular ligament. The common mechanism of injury described and observed has been one of external rotation of the foot relative to the tibia. ⋯ We discuss 2 cases of isolated Tillaux fractures in skeletally mature adults, aged 47 and 37 years, a population in which this fracture pattern to our knowledge and after review of the published data has not been described. It is important to recognize these distinct injuries and appropriately treat the pathologic features to prevent further instability and arthritis.