Lauge Hansen PAB Pronation ABduction (Eversion) Ankle Fracture

Summary

The video explains the stages and X-ray features of a pronation–abduction (eversion) ankle injury. The injury develops when an abductory force acts on a foot held in pronation.

1. Stage 1 — Medial injury: The force acts along the medial side of the ankle, causing a transverse medial malleolar fracture, failure of the deltoid ligament, or both.
2. Stage 2 — Syndesmotic injury: As the talus is pushed laterally, it stresses the tibiofibular syndesmosis and injures the anterior and posterior inferior tibiofibular ligaments. If the interosseous ligament remains intact, the injury should not be called a true diastasis.
3. Stage 3 — Fibular fracture: Continued force produces a short oblique fibular fracture at or above the ankle joint. It appears oblique on an AP X-ray but transverse on a lateral X-ray. A lateral cortical spike may be visible on the AP view, and lateral comminution is common.

A lateral ankle X-ray helps distinguish this fracture pattern from the posterior fibular spike associated with supination–external rotation injuries, which can affect fixation planning. The fracture’s different appearance on AP and lateral views is characteristic of pronation–abduction injuries.

Speakers or Sources Featured

• One educational narrator/voiceover; the subtitles do not identify the speaker by name.