Wagstaffe-Le Fort Fracture

Description

Wagstaffe-Le Fort Fracture: avulsion fracture of the medial aspect of the distal fibula due to avulsion of the anterior tibiofibular ligament attachment (ATFL).

See also:  Tillaux-Chaput avulsion fracture – posterolateral tibia avulsion

History

1875 – William Warwick Wagstaffe reviewed 62 ankle fractures sustained between 1866-1868 following direct and indirect violence. He recorded 2 cases in which he could find ‘no parallel instance to the two which are subjoined‘. Wagstaffe original description:

I find in none of the standard works to which I have able to refer any mention of cases in which the fracture was of the character found in the two cases here recorded. The peculiar feature of these cases was the existence of a vertical fracture of the fibula in its lower end, with a displacement of the fractured portion in such a way that it was twisted round on its long axis.’

Wagstaffe 1875

1886 – Léon Clément Le Fort observed and described 3 clinical cases of isolated fracture of the anterior margin of the lateral malleolus corresponding to the attachment of the ligamentum malleoli lateralis anterius. In his opinion the fracture was produced by forced supination-adduction of the foot.

2002 – Park et al reviewed AITFL avulsion fracture classification. The Wagstaffe fracture (isolated vertical fracture of the distal fibula avulsed by the anterior tibiofibular ligament) was classified as type I, or primary Wagstaffe fracture)

Types of Wagstaffe fractures. (A) Type I, displaced avulsion fracture of the distal end of the fibula. (B) Type II, fracture of the anterior spike of the proximal fibular fragment. (C) Type III, fractures of the anterior tubercles from both of the tibia and fibula

Park et al 2002

2019 – Birnie et al proposed a new AITFL avulsion fracture classification system

Associated Persons

• Léon Clément Le Fort (1829–1893)
• William Warwick Wagstaffe (Sr) (1843-1910)

Alternative names

• Wagstaffe-Le Fort Fracture
• Le Fort-Wagstaffe Fracture
• Wagstaffe Ankle Fracture
• Le Fort Ankle Fracture

References

• Wagstaffe W. An unusual form of fracture of the fibula. Saint Thomas’s Hospital Reports 1875; 6: 43-49
• Le Fort LC. Note sur une variété non decrite de fracture verticale de la malleole externe par arrachement. Bulletin général de thérapeutique médicale, chirurgicale, obstétricale et pharmaceutique. 1886; 110: 193-199 [Note on an undescribed variety of vertical fracture of the lateral malleolus by avulsion.]
• Park JW, Kim SK, Hong JS, Park JH. Anterior tibiofibular ligament avulsion fracture in weber type B lateral malleolar fracture. J Trauma. 2002; 52(4): 655-9.
• Somford MP, Wiegerinck JI, Hoornenborg D, van den Bekerom MPJ. Ankle fracture eponyms. JBJS 2013; 95(24): e198
• Birnie MFN et al. Anterior inferior tibiofibular ligament avulsion fractures in operatively treated ankle fractures: a retrospective analysis. Arch Orthop Trauma Surg. 2019; 139(6): 787-793
• Eponymythology: Eponymous Foot, ankle and talus injuries. LITFL