Niels Lauge-Hansen

Niels Lauge-Hansen (1899 – 1976) was a Danish Radiologist.

Lauge-Hansen (published as Lauge N.) wrote a definitive review of ankle fractures – ‘an analytic historic survey as the basis of new experimental, roentgenologic and clinical investigations‘ 2 years before his classification publication. [Arch Surg. 1948 Mar;56(3):259-317.]

Lauge-Hansen’s research was ground-breaking at its time of publication: Injury spectrum provides clinicians with high index of suspicion for easily missed additional injuries on radiographs; radiographic findings allowed surgeons to predict concurrent soft tissue injuries; and provided basis of closed fracture reduction and immobilisation in an era predation modern surgical fixation

Eponymously linked with the Lauge-Hansen classification of ankle fractures

Biography

Born 1899
Worked primarily at the Central Hospital, Randers, Denmark.
1942 – published his thesis ‘Genetisk Diagnose og Reposition’
1948 – published ‘Ankle fractures 1: the analytical historical survey’, providing a history of ankle fracture management since Hippocrates, forming the basis of his work.
1950 – used fresh cadaveric lower limb amputations, fixed with a vice and nails, to observe a spectrum of ankle injuries. These were demonstrated in force produced by hand to the hindfoot, and formed the basis of his publication ‘Ankle fractures 2: the combined experimental-surgical and experimental roentgenologic investigation’.
1952 – described how to perform closed ankle fracture reduction, based on reversal of injury mechanism, published in ‘Ankle fractures 4: clinical use of genetic roentgenologic diagnosis and genetic reduction’.
1954 – applied previous work to describe his radiographic classification and effect of rotational ankle force on interosseous clear space and mortise, publishing ‘Ankle fractures 3: the genetic roentgenologic diagnosis of fractures of the ankle’.
1959-1961 Worked in Seoul (South Korea), honorary member of the Korean Radiology Association
Died in 1976.

Medical Eponyms

Lauge-Hansen classification of ankle fractures (1950)

Appreciation of ankle injury mechanism furthers understanding of likely associated ligamentous injury, implications of joint stability and management. The Lauge-Hansen classification requires three radiographic views of the ankle (anteroposterior, mortise and lateral) and is characterised with specific two-word descriptors of the injury mechanism:

First word: describes the position of the foot at the time of injury (supination or pronation)
Second word: describes the deforming force direction (abduction, adduction, or external rotation)

Lauge-Hansen’s classification can be difficult to remember and best reviewed in comparison to the simplified Danis-Weber classification. Awareness of the injury mechanism, enhances interpretation and identification of subtle Lauge-Hansen injury stages.

Controversies

Recent research using up to date experimental techniques, has failed to consistently reproduce Lauge-Hansen’s initial findings, questioning the reliability of his classification system. However, the value of his classification when considering concurrent soft tissue injuries, alongside fractures, remains in high regard.