Maisonneuve fracture

A type of fracture involving the fibula and ankle

Maisonneuve fracture is a specific type of injury that involves a fracture of the proximal third of the fibula along with an associated injury to the ankle joint. This injury is named after the French surgeon Jules Germain François Maisonneuve, who first described it in the 19th century.

Anatomy and Pathophysiology

The Maisonneuve fracture is characterized by a fracture of the proximal fibula, which is the smaller of the two bones in the lower leg, located on the lateral side. This fracture is often accompanied by a disruption of the syndesmosis, which is the fibrous joint connecting the distal ends of the tibia and fibula. Additionally, there may be an associated fracture of the medial malleolus or a rupture of the deltoid ligament on the medial side of the ankle.

The injury typically occurs due to a high-energy rotational force applied to the ankle, which is transmitted up the interosseous membrane to the fibula. This mechanism of injury is often seen in sports or accidents where the foot is planted and the body is twisted.

Clinical Presentation

Patients with a Maisonneuve fracture usually present with pain and swelling in the ankle and lower leg. There may be visible deformity or bruising, and the patient may be unable to bear weight on the affected limb. Examination of the ankle may reveal tenderness over the medial malleolus or deltoid ligament, and there may be instability of the ankle joint.

Diagnosis

The diagnosis of a Maisonneuve fracture is typically made through a combination of clinical examination and imaging studies. Radiographs of the ankle and lower leg are essential to identify the fracture of the fibula and any associated injuries to the ankle. In some cases, additional imaging such as MRI or CT scan may be required to assess the extent of soft tissue injury and to plan surgical intervention.

Treatment

The treatment of a Maisonneuve fracture often involves surgical intervention to stabilize the ankle joint and repair any associated ligamentous injuries. This may include fixation of the fibular fracture, repair of the syndesmosis, and stabilization of the medial malleolus or deltoid ligament. Post-operatively, patients may require immobilization in a cast or boot, followed by a period of rehabilitation to restore function and strength.

Prognosis

The prognosis for patients with a Maisonneuve fracture depends on the severity of the injury and the success of the surgical repair. With appropriate treatment, most patients can expect to regain full function of the ankle, although some may experience residual stiffness or discomfort.

Related pages

• Fibula
• Ankle joint
• Syndesmosis
• Medial malleolus
• Deltoid ligament

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