Lauge-Hansen classification of malleolar fractures. An assessment of the reproducibility in 118 cases.

The radiographs of malleolar fractures in 118 consecutive patients were assessed by 4 observers using the Lauge-Hansen classification. The interobserver variation was large; only 51 of the 118 radiographs were classified identically by all 4 observers. With the purpose of assessing intraobserver variation, the same observers classified the same radiographs 6 weeks later. The first and the second classification were identical in 75-97 of 118 radiographs (64-82 percent). These results show that the Lauge-Hansen system is difficult to apply in a reproducible way.