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Introduction

Weber and Lauge-Hansen

Normal flexibility of the ankle

Position of the foot

Pull-off or Push-off fractures Stability

Ottawa Ankle Rules

Radiography

Mortise view

Lateral view

Classification

Weber A - Lauge Hansen SA

Weber B - Lauge Hansen SE

Weber C - Lauge Hansen PER

Who needs additional radiographs of the lower

extremity?

Interpretation and Reporting

Examples

back to overview print

Publicationdate:15-12-

2010

The ankle is the most frequentlyinjured joint.

Management decisions are based

on the interpretation of the AP and

lateral X-rays.

Classification of ankle fractures is

important in order to estimate the

extent of the ligamentous injury

and the stability of the joint.

In this article we will combine the

simplicity of the Weber

classification system with thestages of the Lauge-Hansen

system.

Next we will focus on the

interpretation of X-rays of the

injured ankle using these

classifications.

You can enlarge images byclicking on them.

This item is not available on the

iPhone application. Introduction

Weber and Lauge-Hansen

On the left an overview of the two

most commonly applied

classification systems for ankle

fractures.

The Weber system

This system focuses on the

integrity of the syndesmosis.It owes its popularity mainly to its

simplicity.

Type A occurs below the

syndesmosis, which is

intact.

Type B is a

transsyndesmotic fracture

with usually partial - and

less commonly, total -

rupture of the syndesmosis. Type C occurs above the
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level of the syndesmosis

with usually a total rupture

of the syndesmosis, and

consequently instability of

the ankle mortise.

The Lauge-Hansen system

This system focuses on the trauma

mechanism.

Based on the findings on the

radiographs you deduce what the

trauma mechanism must have

been.

It stages the severity of the injury,

which allows you to predict theligamentous injury and instability.

This system is based on:

Position of the foot at the

moment of injury, either in

supination (80%) or in

pronation (20%)

Direction of the force on

the foot within the ankle

mortise, which is either

exorotation (80%) or

adduction (20%).

We will discuss this system

in more detail below.Normal flexibility of the ankle

The ankle joint has to be flexible

in order to deal with the enormous

forces applied exerted on the talus

within the ankle fork. .The medial side of the joint is

quite rigid because the medial

malleolus - unlike the lateral

malleolus - is attached to the tibia

and the medial collateral ligaments

are very strong.

On the lateral side there is a

flexible support by the fibula,

syndesmosis and lateral collateralligaments.

This lateral complex allows the
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talus to move laterally and

dorsally in exorotation during

forward motion and subsequently

pushes it back into its normal

position.The fibula has no weight-bearing

function, but merely serves as a

flexible lateral support.

The syndesmosis is the fibrous

connection between the fibula and

tibia formed by the anterior and

posterior tibiofibular ligaments -

located at the level of the tibial

plafond (French for ceiling) - and

the interosseus ligament, which is

the thickened lower portion of theinterosseus membrane.

The anterior and posterior

tibiofibular ligaments are often

referred to as anterior and

posterior syndesmosis.Position of the foot

There are two positions of the foot

in which the flexible ankle joint

becomes a rigid and vulnerable

system: extreme supination andpronation.

In these positions forces applied to

the talus within the ankle mortise

can result in fractures of the

malleoli and rupture of the

ligaments.

In 80% of ankle fractures the foot

is in supination.

The injury starts on the lateral

side, since that is where themaximum tension is.

In 20% of fractures the foot is in

pronation with maximum tension

on the medial side.

The injury starts on the medial

side with either a rupture of the

medial collateral ligaments or an

avulsion of the medial malleolus.
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Pull-off or Push-off fractures

The shape of a fracture indicates

which forces were involved. An

oblique or vertically oriented

fracture indicates 'push-off'.A transverse or horizontal fracture

is the result of a 'pull-off'.

On the left image the lateral

malleolus is pushed off by

exorotation of the talus.

On the right image the medial

malleolus is pulled off by the

medial collateral ligament due to

pronation of the foot.Stability

The ankle can be thought of as a

ring in which bones as well as

ligaments play an equally

important role in the maintenance

of joint stability.

If the ring is broken in one place

the ring remains stable.

When it is broken in two places,

the ring is unstable and may

dislocate.

Now it is easy to say that an ankleis unstable when both the medial

and the lateral malleoli are

fractured.

It becomes more problematic

when there is a combination of a

fracture and a ligamentous rupture,

because the ligamentous rupture

may not be detectable on the X-

ray.

In some fractures there may even

be a proximal fibular fracture -which is not visible on the ankle

radiographs - in combination with

a medial ligamentous rupture.

It is important to realize that the

radiographs of an ankle may be

normal in cases with an unstable

ankle injury.
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Stability (2)

On the left image a Weber A or

SA-fracture.

This ankle is stable because there

is only an avulsion fracture of the

lateral malleolus below the levelof the syndesmosis.

The ring is broken in only one

place.

On the right image there is an

unstable fracture.

The ring of the ankle is broken in

two places.

There is a lateral fracture and on

the medial side there is a rupture

of the collateral ligament allowingthe talus to dislocate laterally.

Stability (3)

The medial clear space should not

exceed 4 mm and is usually equal

to the distance between the tibial

plafond and the talus.

Widening of the medial joint space

up to 6 mm or more requires

disruption of the medial collateral

ligament.

Stability (4)

The lateral clear space is

measured from the medial border

of the fibula to the lateral border

of the posterior tibia 1cm above

the tibial plafond.

It is less well defined because its

width varies with positioning.

Evident widening of the lateral

clear space indicates syndesmotic

rupture.Some state that a width of 5.5 mm

is abnormal.

It is very important to realize that

a normal lateral or medial clear

space does notexclude

ligamentous rupture.

It simply means that there is no

dislocation, but there can still be

instability.

The case on the left shows a

Weber B fracture.On these images the ankle fork is
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normal.

Both the medial and lateral clear

spaces are prominent, but within

normal limits.

We can conclude that there is no

dislocation, but we do not know ifthere is rupture of the medial

collateral ligaments or of the

syndesmosis.

Continue with the images post

surgery.

Following osteosynthesis there is

obvious widening of the medial

and lateral clear spaces (image on

the far left).

This indicates that there is a

syndesmotic rupture and medialcollateral ligament rupture.

The ring is still broken in two

places.

The ankle joint is unstable and

dislocated.

Resurgery was necessary with

placement of a syndesmotic screw

to stabilize the ankle joint.

Stability (5)

On the left another case. There is a

Weber B fracture.

Both the medial and lateral clear

spaces are widened, indicating

instability.

The talus is displaced laterally.

Patient was scheduled for

osteosynthesis of the fibular

fracture and placement of a

syndesmotic screw if necessary.

After osteosynthesis of the fibula,

the ankle was tested in theoperating room and found to be

stable.

There was no indication for a

syndesmotic screw.

It was concluded that the

syndesmosis was only partially

ruptured, as is usually the case in

Weber B fractures.

The ring was broken in two places

and after repairing one of them,

the ring was stable.Ottawa Ankle Rules


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These rules are used to determine

the need for radiographs in

patients with an ankle injury.

Ankle X-ray series are only

required in case of:

Pain in the malleolar zone and any

one of the following:

Bone tenderness along the

distal 6 cm of the posterior

edge of the fibula or tip of

the lateral malleolus.

Bone tenderness along thedistal 6 cm of the posterior

edge of the tibia or tip ofthe medial malleolus.

Inability to bear weight for4 steps both immediatelyand in the emergency

department.Radiography

Mortise view

A basic radiographic examination

consists of a Mortise-view and alateral view. Some add the AP-

view.

The Mortise-view is an AP-view

taken with a 15-25 endorotation

of the foot.

The technologist turns the foot

inwards until the lateral malleolus

is at the same height as the medial

malleolus.

This view visualizes both the

lateral and medial joint spaces..On a true AP-view the talus

overlaps a portion of the lateral

malleolus, obscuring the lateral

aspect of the ankle joint.
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The distal fibula should project on the posterior part of the

distal tibia

Lateral view

Many think that for a good lateral

view the distal fibula should be in

the center of the distal tibia.

However, since the fibula ispositioned more dorsally, the

fibula should project over the

posterior part of the distal tibia

(arrow).

ClassificationWeber A - Lauge Hansen SA

This is the most simple ankle

fracture.

The diagnosis as well as the

treatment usually poses no

problems.

It occurs in about 20-25% of all

ankle fractures.

The foot is fixed on the ground in

supination when an adduction

force is applied to the talus.

The first injury will occur on thelateral side, which is under

tension.

Stage 1Supination results in a tear of the

lateral collateral ligament or an

avulsion fracture of the lateral

malleolus below the level of the

tibial plafond, i.e below the level

of the syndesmosis.

Stage 2More talar tilt results in the medial

malleolus beingpushed offin a

vertical or oblique way .

This second stage is very

uncommon and is unstable.
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Weber A Fracture or SA according to Lauge Hansen

On the left a simple Weber A -

Lauge Hansen SA fracture.

Since the syndesmotic ligaments

are intact, the ankle mortise is

stable.

VIDEO: Weber A or Supination Adduction injury

If the video doesn't play simply push the stop button and

the play button again.

Start the video on the left by

clicking on the image.

Notice that at first the foot is in

supination with maximal forces on

the lateral side.

Subsequently the foot adducts.

The result is an SA or Weber A

fracture.

We can assume that this is the

uncommon stage 2.

Before we continue with the

Weber B and C fractures, it isimportant to understand that most

malleolar fractures have a

ligamentous counterpart and vice

versa (Table).

The Tillaux fracture is an avulsion

fracture of the tibia where the

anterior syndesmosis attaches.

It is an uncommon finding.
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Weber B - Lauge Hansen SE

This is the most common type and

occurs in about 60-70% of all

ankle fractures.

The foot is fixed on the ground insupination and an exorotation

force is applied to the talus due to

an endorotation of the lower leg.

Stage 1

The first injury will occur on the

lateral side, which is under

maximum tension. As the talus

exorotates, the anterior tibiofibular

ligament ruptures first.

Stage 2Since the foot is in supination, the

lateral malleolus is held tightly in

place by the lateral collateral

ligaments and cannot move away

without breaking. As a result more

rotation of the talus will fracture

the fibula in an oblique or spiral

fashion because the lateral

malleolus ispushed offfrom

anterior to posterior.

The fracture starts at or only a fewcms above the level of the ankle

joint and extends proximally.

Stage 3

Posterior displacement of the

lateral malleolus fragment by the

talus results in rupture of the

posterior tibiofibular ligament or

avulsion of the malleolus tertius.

Stage 4

More posterior movement of the

talus will result in extreme tensionon the medial side and the deltoid

ligament will either rupture orpulloffthe medial malleolus in the

transverse plane.
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In Weber B or supination exorotation injury the eventstake place in a clockwise manner

The sequence of events in a Weber

B fracture or Lauge-Hansen

supination exorotation injury

happens in a clockwise sequence:

1. Rupture of the anteriortibiofibular ligament

2. Oblique fracture of the

distal fibula

3. Avulsion of the posterior

malleolus or rupture of the

posterior tibiofibular

ligament

4. Avulsion of the medial


medial collateral ligament

Immediately after the injury the

injured parts may again align,

which can make it difficult to

detect the fractures and

ligamentous ruptures.

Study the images on the left and

try to find out which stage is

present.

On the left an oblique fibular

fracture which is typical for a

Weber B or SER (Lauge-Hansen)

fracture.

According to Lauge-Hansen this is

stage 2, so we must assume that

there is also a rupture of the

anterior syndesmosis, i.e. stage I.

Now we look for stage 3 and we

notice a subtle irregularity of theposterior aspect of the tibia (black

arrow).

This is probably the result of an

avulsion of the malleolus tertius.

Finally, we also notice widening

of the medial clear space (red

arrow), which indicates a rupture

of the medial collateral ligaments,

i.e. stage 4.

This ankle is unstable and

osteosynthesis is necessary.
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Weber C - Lauge Hansen PER

This is seen in approximately 20%

of ankle fractures.

The foot is fixed on the ground in

pronation when an exorotationforce is applied to the talus.

Stage 1The first injury will occur on the

medial side, which is under

maximum tension. It will lead to

rupture of the medial collateral

ligament or avulsion of the medial

malleolus .

Stage 2

The talus rotates externally andmoves laterally because it is free

from its medial attachment. Due to

the pronation, the lateral side is

not under tension and the fibula

can move away fron the tibia. This

causes rupture of the anterior

syndesmotic ligament.

Stage 3The fibula will be twisted distally,

while proximally it is fixed in

position. Finally the interosseusmembrane will rupture up to the

point where the fibular shaft

fractures above the level of the

syndesmosis. The fibular fracture

may or may not be visible on the

ankle X-rays. Stage 4

Finally the posterior syndesmotic

ligament ruptures, or there is an

avulsion of the posterior

malleolus, also known as the

malleolus tertius.
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The sequence of events in a Weber

C fracture or Lauge-Hansen

pronation exorotation injury also

happens in a clockwise sequence:

1. Avulsion fracture of themedial malleolus or medial

collateral band rupture

2. Rupture of the anterior

tibiofibular ligament

3. High transverse fracture of

the fibula

4. Avulsion of the posterior


posterior tibiofibular

ligament

After the event the pieces may

align again and be difficult to

detect on the radiographs.

Most ligamentous injuries will not

be visible on the x-rays unless

there is a widened lateral or medial

clear space.

Weber C or Lauge Hansen SER stage 4.

On the left a typical Weber C

fracture above the level of the

syndesmosis.

Lauge-Hansen has demonstrated

that this is the result of an

exorotation force on a foot in

pronation.

The fibular fracture means PER

stage 3.

This means that there is also:

stage 1: rupture of the medial

collateral ligaments andstage 2: rupture of the anterior

syndesmosis.

Now we study the images to look

for stage 4.

It is not easily seen, but there is

also a tertius fracture, which

means stage 4.

Knowledge of the stages according

to Lauge-Hansen helps us to detect

fractures which are not easilydetected at first glance.
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We also know when the ligaments

must be ruptured.

VIDEO: Weber C or Pronation exorotation injury Start the video on the left by

clicking on the image.

Notice that at first the foot is in

pronation, with maximum forceson the medial side.

Subsequently the foot exorotates.

The result is a PER - pronation

exorotation injury or Weber C

fracture.

Who needs additional radiographs ofthe lower extremity?

All Weber A and B fractures

should be visible on standard

radiographs of the ankle.

So in these cases there is no needfor extra films of the lower leg.

In Weber C or pronation

exorotation injury the fibular

fracture can be located proximally

and not visible on radiographs of

the ankle.

We need to look for a high fibular

fracture when there is any of the

following:

Isolated fracture of the

medial malleolus


malleolus tertius without a

fracture on the lateral side

Any painful swelling or

hematoma on the medialside without a fracture onthe radiographs
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Isolated fracture of the medial

malleolus

According to Lauge-Hansen this is

the first stage of a PER injury.

So we have to look for higher

stages.

The injury can continue to the

following:

stage 2: rupture of the

anterior syndesmosis

stage 3: high fibular

fracture


posterior syndesmosis

In all these subsequent stages,

purely ligamentous injury will not

be visible on the radiographs of

the ankle.

So even in Weber c fracture or

PER stage 4 sometimes only a

fracture of the medial malleolus

will be visible.


malleolus tertius

Truly isolated fractures of the

posterior malleolus are very

uncommon.

Most fractures of the posterior

malleolus are part of a complex

ankle injury, either Weber B

(SER) or Weber C (PER).

A Weber B fracture is easily

detected because of thecharacteristic oblique fracture.

According to Lauge-Hansen, a

posterior malleolus fracture is

stage 4 of a PER injury.

So if we have the following

combination:


medial collateral ligament

stage 2: rupture of theanterior syndesmosis
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fracture

stage 4: tertius fracture

An isolated tertius fracture on an

ankle radiograph indicates the

presence of an unstable ankle

fracture.

Any medial painful swelling or

hematoma without a visible

fracture on ankle radiographs

Normal radiographs do not rule

out a Weber C fracture or Lauge-

Hansen PER stage 4, which is a

serious, often unstable, ankleinjury.

In that case we have the following

combination:


medial collateral ligament,

which causes the swelling

and hematoma


anterior syndesmosis


fracture - not visible on the

radiographs of the ankle


posterior syndesmosisInterpretation and Reporting
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Start with a basic interpretation

and look for fractures and signs of

ligamentous rupture.

This interpretation will direct you

to both a Weber as well as a

Lauge-Hansen classification.The Lauge-Hansen classification

will give you the fracture

mechanism and the preliminary

stage of the ankle injury.

Now re-examine the films to make

sure that you do not overlook a

higher grade ankle injury.

After this re-examination you can

make a final report.

In the final report the fracture is

described according to Weber

and/or Lauge-Hansen.

Describe the number of malleoli

involved and whether there are

signs of instability or dislocation.Examples

Case 1

Basic interpretationThere is a pull-off fracture

of the lateral malleolus

below the level of the tibial

plafond, i.e below the level

of the syndesmosis.

First impressionWeber A fracture or

Lauge-Hansen supination

adduction injury stage 1.

Re-examination

Look for the uncommonstage 2, but there is no

fracture on the medial side.

Final reportWeber A fracture or


adduction injury stage 1.

The ankle is stable.
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Case 2

Basic interpretationThere is a typical oblique

fracture of the lateral

malleolus (push-off) at thelevel of the syndesmosis.

The medial clear space

looks widened.

First impressionWeber B fracture or


exorotation injury stage 2

or more, i.e. rupture of the

anterior talofibular

ligament and oblique

fracture of lateralmalleolus.

Re-examinationLook for stage 3, i.e.

avulsion of the malleolus

tertius or widening of the

lateral clear space due to

rupture of the posterior

syndesmosis.

We also look for stage 4,

i.e. rupture of the medial

collateral ligament or

avulsion of the medial

malleolus.

Re-examinationBoth the medial and lateral

clear spaces are widened.

There is a subtle linear

lucency in the distal tibia,

which indicates a fracture

of the malleolus tertius(arrow).

Final reportWeber B fracture or


exorotation injury SER

stage 4.

The ankle is unstable.

Osteosynthesis of the

fibular fracture is

necessary.If this does not restore the
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ankle mortise and the

medial clear space remains

widened, a syndesmotic

screw must be inserted and

an exploration of themedial ankle joint

performed to look for

interpositioned ruptured

ligaments.

Case 3

Basic interpretation

This is an AP-view while a

Mortise-view is preferable.

There is a soft tissue

swelling on the lateral side.On the lateral view there is

an oblique fracture line.

First impressionWeber B fracture or


exorotation injury stage 2

or higher, i.e. rupture of the

anterior talofibular

ligament and oblique


malleolus.

Re-examinationNo sign of a posterior

malleolus fracture or

fracture of the medial

malleolus.

Based on the radiographs

we cannot exclude a

rupture of the posterior

syndesmosis or a rupture of

the medial collateralligaments.

This still can be a Lauge-

Hansen SER stage 4 injury,

i.e. an unstable fracture.

At physical examination

however there was no

swelling, tenderness or

hematoma on the medial

side, so we can exclude a

stage 4 injury.

A stage 3 injury is still
http://www.radiologyassistant.nl/images/4d053f8895ca8weber-b-1-ap-niet-optimaal.jpg


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possible.

Final reportWeber B fracture or

Lauge-Hansen SER stage 2

or 3.Case 4

Basic interpretationOblique fracture at the

level of the syndesmosis.

First impressionWeber B or SER (Lauge-

Hansen) fracture stage 2.

Re-examinationWidened medial and lateral

clear space indicating astage 4 SER injury.

So there also must be a

stage 3, i.e. posterior

syndesmotic rupture or

avulsion of the malleolus

tertius.

Final reportWeber B or SER (Lauge-

Hansen) fracture stage 4.

This fracture can be

unstable.

This patient was scheduled for

osteosynthesis of the fibular

fracture and placement of a

syndesmotic screw if necessary.

After osteosynthesis of the fibula,

the ankle was tested in the

operating room and found to bestable.

Thererefore there was no

indication for placing a

syndesmotic screw.

It was concluded that the

syndesmosis was only partially

ruptured, which is not uncommon

in Weber B - SER fractures.


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Case 5

Basic interpretationIn the images on the left

we notice the fracture of

the posterior malleolus.

First impressionClassification is not

possible.

Since an isolated fracture

of the posterior malleolus

is uncommon, we have to

re-examine the films to

look for signs of a Weber

B or C fracture.

Re-examinationNo sign of an oblique


malleolus, so we can

exclude a Weber B

fracture.

There is still the possibility

of a Weber C fracture, i.e.

medial rupture or avulsion,

high fibular fracture and

finally a posterior

malleolar fracture.

Now we notice the subtle

avulsion of the medial

malleolus (arrow).

Additional radiographs of

the lower extremity

demonstrate a high fibular

fracture, also known as a

Maisonneuve fracture.

Final reportWeber C fracture or

Lauge-Hansen PE stage 4.

The lesson learned in this case is

that any patient with a hematoma

or swelling on the medial side of

the ankle may have a Weber C

fracture or a Lauge-Hansen PE

injury stage 1-4.
http://www.radiologyassistant.nl/images/4d05454a582d8weber-c-mall-3B.jpghttp://www.radiologyassistant.nl/images/4d0542be4f964weber-c-mall-3.jpg


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Case 6

Basic interpretationOn the left images of a

patient with a hematoma

on the medial side. Nosigns of a fracture.

First impressionClassification is not

possible.

Re-examinationWe can exclude a Weber A

or B fracture, because we

see no fracture.

A Weber C or Lauge-

Hansen PE injury is still a

possibility, i.e. medial

ligament rupture, high

fibular fracture and finally

a posterior syndesmosis

rupture.

Additional radiographs of

the lower leg demonstrate

the high fibular fracture,

also known asMaisonneuve fracture.

Final reportWeber C fracture or

Lauge-Hansen PE stage 3

or 4, i.e. medial collateral

ligamentous rupture,

rupture of the anterior

syndesmosis, high fibular

fracture and probably a

rupture of the posteriorsyndesmosis.

The lesson in this case is that any

patient with a hematoma or

swelling on the medial side may

have a Weber C fracture or a

Lauge-Hansen PE injury stage 1-4.

References

1. Fractures of the ankle, combined experimental-surgical and experimental-

roentgenologic investigations

by N. Lauge-Hansen (1948)
http://www.radiologyassistant.nl/images/4d054a85c894fcase-weber-c-norm-enkelB.jpghttp://www.radiologyassistant.nl/images/4d054691c7ca6case%20weber%20c%20norm%20enkel.jpg


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2. Die verletzungen des oberen sprunggelenkes

by B.G. Weber (1966)

3. Website of the Ottawa Ankle rules

4. Ankle fractures

East Lancashire Foot and Ankle Hyperbook

5. Free AO Surgery ReferenceThe AO Surgery Reference is a huge online repository of surgical knowledge,

consisting of more than 7000 pages.
http://www.ohri.ca/programs/clinical_epidemiology/OHDEC/ankle_rule/flash_ankle_rule.htmhttp://www.foothyperbook.com/trauma/malleolarFx/ankleFxIntro.htmhttp://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3hng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFIHr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEwOEVSRTAySjNONjQwSTEwRzA!/?showPage=diagnosis&bone=Tibia&segment=Malleolihttp://www.ohri.ca/programs/clinical_epidemiology/OHDEC/ankle_rule/flash_ankle_rule.htmhttp://www.foothyperbook.com/trauma/malleolarFx/ankleFxIntro.htmhttp://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3hng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFIHr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEwOEVSRTAySjNONjQwSTEwRzA!/?showPage=diagnosis&bone=Tibia&segment=Malleoli


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GARZI REZIDENTI LUNA AUGUST 2011

DA

TA

ZIUA LINIA 1

CT

LINIA 2

CT

LINIA 3

RX

LINIA 4

RX

1 L JURJ ANA MARIA BARNEA LAURENTIU LOIS IUSTIN COMSA MIHAI

2 M BOJA RAMONA DUMINECA IULIA TODA CORNELIA MOLDOVAN RAMONA

3 M LEBOVICI ANDREI DRAGOMIR MIHAI BAJAN RALUCA AL KOUZ MARWAN

4 J CRAMARIUC RADU BARSAN CRISTIAN DEAC DIANA DAN MARIAN

5 V BERCEA MIHAIL MOLNAR LAURA HASHMI JUNAID HASHMI JAWAD

6 S BOGDAN NICU CAMPEAN ANDREI TAMAS-SZORA ATTILA ABDALAH AMIR

7 D BAHLE RUBEN MAXIM DIANA MUSTE FLORIN VAINAK NICOLAE

8 L OPREA IOAN TATARU MIHAI VIDA ALINA NAGY ERIKA

9 M NEGREANU RARAES CONT DANIEL COTARLEA VALENTIN FILEP ALEXANDRU

10 M DUMA DAN PARASCA ANDREEA OBADA OANA MOALE MIHAI

11 J POPA ROXANA BERCEA MIHAIL DOMINTE MIHAELA FLORIA DIANA

12 V LEBOVICI ANDREI DRAGOMIR MIHAI CIUCA ANDREI AL KOUZ MARWAN

13 S FEIER DIANA BESSENYEI JULIA BAJAN RALUCA DAN MARIAN

14 D CRAMARIUC RADU NEGREANU RARES MARGINEAN MARIUS TODA CORNELIA

15 L - - - -

16 M CONT DANIEL ZSEBE ERIKA GHITA CAMELIA LUCACI ESTERA

17 M POPA LOREDANA DASCALESCU DIANA POP TEODORA DEE ANA MARIA

18 J VINTILESCU ADELINA TATARU MIHAI COMSA MIHAI BOURGUIBA MED

KARIM

19 V MORAR VASILE TRIKI HAFEDH GORI MARIANA PASCA ALEXANDRA

20 S JURCA LAURENTIU ISSE OMAR MOLDOVAN IONUT TIMIS BOGDAN

21 D OPREA IOAN POPA ROXANA MARDALE STEFAN CHIOREAN LILIANA

22 L TOMA VIRGINIA COSARCA MIHAELA MARGINEAN MARIUS BERINDE ELENA

23 M SOCACIU MIHAI MOLNAR LAURA MARCU DANIELA GHITA CAMELIA

24 M POP MANUELA ILE-PIRTEA

LOREDANA

MOALE MIHAI CIUCA ANDREI

25 J FEIER DIANA MAXIM DIANA HASHMI JUNAID HASHMI JAWAD

26 V ZSEBE ERIKA PARASCA ANDREEA FILIP CRISTIAN VAINAK NICOLAE

27 S DASCALESCU DIANA DUMA DAN FILEP ALEXANDRU PASCA ALEXANDRA

28 D CONT DANIEL VINTILESCU ADELINA DEAC DIANA DEE ANA MARIA

29 L DUMINECA IULIA CAMPEAN ANDREI GORI MARIANA POO TEODORA

30 M JURCA LAURENTIU SIPOS SERENELA MOLDOVAN RAMONA OBADA OANA

31 M JURJ ANA MARIA BARNEA LAURENTIU BUTE NICOLETA BERINDE ELENA

COORDONATOR PROF. DR. SILVIU A. SFRANGEU

fracturi glezna

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