COMPARATIVE DESCRIPTION OF THE DANIS-WEBER, AO, LAUGE HANSEN AND DIAS-TACHDJIAN CLASSIFICATION SYSTEMS FOR ANKLE FRACTURES

Abstract

Introduction: Ankle fractures are very common in emergency departments around the world. Through time and scientific advances, several means of classification have been structured with regard to ankle fractures. The most frequent, recognized and used classification systems in ankle fractures at the moment are those of Lauge-Hansen, the AO/OTA system, Danis-Weber in adults and Dias-Tachjian in pediatrics. Objective: to detail the current information related to the Danis-Weber, AO, Lauge-Hansen and Dias-Tachdjian classification systems for ankle fractures. Methodology: a total of 37 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 24 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: ankle fracture classification, AO classification, Danis-Weber classification, Lauge Hansen classification and Dias-Tachdjian classification. Results: In day-to-day clinical practice, the fracture itself is usually descriptively classified as a uni-, bi- or trimalleolar fracture. In the Lauge and Hanssen system, supination-adduction ranges from 10 to 20%, supination-external rotation ranges from 40% to 75%, pronation-abduction ranges from 5% to 20% and pronation-external rotation accounts for 5% to 20% of malleolar fractures. The Dias-Tachdjian system shows that supination injuries are more frequent than pronation injuries, accounting for up to 82% of all ankle fractures, with supination-inversion being the most common, accounting for about 61% of all pediatric ankle fractures. With regard to the AO/OTA classification, the most common infrasyndromal fractures are A1 (isolated): 68.9%, followed by A2 (bimalleolar): 24.8% and finally A3 (trimalleolar): 6.3%. Trans-ankle fractures account for 85% of ankle fractures. Suprasyndesmal fractures are type C of the Weber classification and following the AO/OTA classification, type 44C1 would be the most common (5.3%). Conclusions: the importance of fracture classification systems is crucial in the choice of treatment, both conservative and surgical, as well as in the future prognosis of the affected individual. The most frequent, recognized and used classification systems in ankle fractures at the moment are those of Lauge-Hansen, the AO/OTA system, Danis-Weber in adults and Dias-Tachjian in pediatrics. In addition to the classification systems cited in this article, there are others, which may have relevance depending on the individual situation. It is important to emphasize that most of the classifications are based on a complementary study, such as radiographs or others, so knowing how to order the appropriate study and incidences helps in the future treatment of the patient with the aim of a speedy recovery. KEY WORDS: classification, fractures, ankle, systems, trauma.