To protect against malleolar fractures in frontal crashes it is important to understand the mechanisms of injury. We have investigated the accuracy of Orthopaedic Specialists in deducing the injury mechanisms of experimentally generated malleolar fractures from radiographs; and the applicability of classic descriptors of injury mechanisms, such as the Lauge-Hansen classification system, in analysing impact induced trauma. Orthopaedic Specialists did not consistently deduce the mechanism of ankle injuries suggesting there may not be a unique fracture pattern for every injury mechanism and that the Lauge-Hansen classification system does not reliably describe ankle fractures created in the impact environment.