Lauge Hansen SER Supination External Rotation (Eversion) Ankle Fracture

© 2010
www.DrGlass.org
glass.dpm@gmail.com

With the foot in a fixed supinated position the forces start along the lateral axis of the fibula. The leg undergoes an internal rotation creating tension on the anterior inferior tibio-fibular ligament.  In a Stage 1 injury, one of two pathologies may occur; rupture of the anterior inferior tibio-fibular ligament or a fracture of the distal lateral tibia (aka Tillaux-chaput fracture).

As the leg continues to internally rotate the talus collides with the distal fibula, creating a spiral fracture of the fibula beginning at the level of the syndesmosis. This describes a Stage 2 injury, which is the most commonly encountered ankle fracture. A Wagstaffe fracture can also occur during this stage. 

As the force progresses a Stage 3 injury will either involve a rupture of the posterior tibio-fibular ligament or fracture of the posterior malleolus of the tibia (aka Volkman's fracture).
 
Supination external rotation injuries that reach stage 3 rarely stop at this point and usually progresses to the final stage. Continued unrestrained lateral rotation of the talus will result in a Stage 4 injury involving either a rupture of the deltoid ligament complex or a transverse fracture of the medial malleolus.
 
(Take home points)
-The injury begins along the lateral axis of the fibula.
-The spiral fracture seen in stage 2 is unique to supination-external rotation injuries.

Project Leads:
William Hoffman
Hummira Hassani

Contributing Authors:
Julia Bernardini
Scott Crismon

Technical Advisor:
Thomas Vitale

Narration:
Matrona Giakoumis

Producer:
Nicholas Giovinco

© 2010
www.DrGlass.org
glass.dpm@gmail.com

Category:

Education

Tags:

• medicine
• Podiatry
• Podiatric
• surgery
• orthopedic
• reconstruction
• screw
• plate
• foot
• ankle
• toe
• arch
• leg
• lower
• extremity
• hammer
• pain
• nerve
• neuroma
• metatarsal
• phalanx
• phalangeal
• joint
• MPJ
• MTPJ
• bunion
• fracture
• break
• bone
• ligament
• sprain
• supination
• pronation
• injury
• eversion
• inversion
• high
• low
• strain
• diastasis
• operation
• fixation
• lauge
• hansen
• SA
• PA
• SER
• PER
• one
• two
• three
• four
• stage
• danis
• weber
• classification
• internal
• external
• rotation
• over
• broken

[BridgeLoungeFL]

narrator's voice is annoying and distracting. Otherwise, graphics, mechanism of injury, well done

[DrGlassDPM]

@BridgeLoungeFL I'lll have to improve that for future projects.

[moinkhanmd]

great animation

[DrGlassDPM]

@moinkhanmd Thanks

[hotingneusvoel]

Dr Glass, awesome videos!

Clarification!

[DrGlassDPM]

@hotingneusvoel No problem.  I'm glad you found it useful

[DrGlassDPM]

@doctormoo NY accents are quite particular, indeed...

[doctormoo]

I dont like her accent.. very weird... she pronounced foot as for

[doctormoo]

I dont like her accent.. very weird