Classification and treatment of ankle fractures

Treatment of ankle fractures should restore normal ankle joint anatomy. The systematic approach in analysis based on understanding of the anatomy, the roentgenograms and the mechanism of injury allow one to determine the elements of the lesion. The Lauge-Hansen classification is most helpful because it takes into account the ligamentous damage that may have occurred, therefore, giving one a better appreciation of the extent of the injury. Open reduction that accurately restores the joint anatomy produces the best and most enduring end-results. Early mobilization of the ankle is possible when internal fixation has produced stability that withstands the dynamic activity of controlled use. A "cook book" approach should not be used; rather, the fundamental principles should be understood, and then the methods of treatment will be self-evident.