lauge-hansen classification lauge-hansen classification the lauge-hansen classification is a system of categorizing ankle fractures based on the foot position and the force applied. classification grade sequence supination-adduction talofibular ligament sprain or distal fibular avulsion fracture vertical medial malleolus fracture and impaction of anteromedial distal tibia supination-external rotation anterior tibiofibular ligament sprain lateral short oblique fibular fracture (anteroinferior to posterosuperior) posterior tibiofibular ligament rupture or avulsion of posterior malleolus medial malleolus transverse fracture or disruption of deltoid ligament pronation-abduction medial malleolus transverse fracture or disruption of deltoid ligament anterior tibiofibular ligament sprain transverse comminuted fracture of the fibula above the level of the syndesmosis pronation-external rotation medial malleolus transverse fracture or disruption of deltoid ligament anterior tibiofibular ligament disruption lateral short oblique or spiral fracture of fibula (anterosuperior to posteroinferior) above the level of the joint posterior tibiofibular ligament rupture or avulsion of posterior malleolus