Maisonneuve fracture
Updates to Article Attributes
Maisonneuve fracture is the combination of a spiral fracture of the proximal fibula and unstable ankle injury which could manifest radiographically by widening of the ankle joint due to distal tibiofibular syndesmosis and/or deltoid ligament disruption, or fracture of the medial malleolus. It is caused by pronation external-rotation mechanism. It requires surgical fixation. 5
Radiographic features
Plain radiograph
Ankle views may either show a fracture of the medial malleolus or widening of the ankle joint due to disruption of the distal tibiofibular syndesmosis (lateral talar shift) or deltoid ligament complex.
When these ankle injury types are seen, further imaging of the entire fibula is recommended to assess for an accompanying proximal fibular shaft fracture.
Treatment
This type of fracture always requires stabilisation of the distal tibiofibular syndesmosis, unless the patient is deemed not suitable for surgery. This is usually achieved by either screws placed across the ankle joint which are then removed after 3 months. The alternative is fibre wire construct which is placed across the ankle which need not be removed, this is often not favoured due to the cost associated with the prothesis. The associated medial malleolus fracture usually requires fixation while the proximal fibula fracture and deltoid ligament injury can be managed without surgical intervention 6.
History and etymology
It is named after Jules Germain Francois Maisonneuve, French surgeon (1809-1897) 4.
-<p><strong>Maisonneuve fracture</strong> is the combination of a spiral fracture of the proximal <a href="/articles/fibula">fibula</a> and unstable ankle injury which could manifest radiographically by widening of the ankle joint due to distal <a href="/articles/distal-tibiofibular-syndesmosis">tibiofibular syndesmosis</a> and/or <a href="/articles/deltoid-ligament-of-the-ankle-1">deltoid ligament</a> disruption, or fracture of the medial malleolus. It is caused by pronation external-rotation mechanism. It requires surgical fixation. <sup>5</sup></p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>Ankle views may either show a fracture of the medial malleolus or widening of the ankle joint due to disruption of the distal <a href="/articles/distal-tibiofibular-syndesmosis">tibiofibular syndesmosis</a> (lateral talar shift) or <a href="/articles/deltoid-ligament-of-the-ankle-1">deltoid ligament complex</a>.</p><p>When these ankle injury types are seen, further imaging of the entire fibula is recommended to assess for an accompanying proximal fibular shaft fracture.</p><h4>History and etymology</h4><p>It is named after <strong>Jules Germain Francois Maisonneuve</strong>, French surgeon (1809-1897) <sup>4</sup>.</p>- +<p><strong>Maisonneuve fracture</strong> is the combination of a spiral fracture of the proximal <a href="/articles/fibula">fibula</a> and unstable ankle injury which could manifest radiographically by widening of the ankle joint due to distal <a href="/articles/distal-tibiofibular-syndesmosis">tibiofibular syndesmosis</a> and/or <a href="/articles/deltoid-ligament-of-the-ankle-1">deltoid ligament</a> disruption, or fracture of the medial malleolus. It is caused by pronation external-rotation mechanism. It requires surgical fixation. <sup>5</sup></p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>Ankle views may either show a fracture of the medial malleolus or widening of the ankle joint due to disruption of the distal <a href="/articles/distal-tibiofibular-syndesmosis">tibiofibular syndesmosis</a> (lateral talar shift) or <a href="/articles/deltoid-ligament-of-the-ankle-1">deltoid ligament complex</a>.</p><p>When these ankle injury types are seen, further imaging of the entire fibula is recommended to assess for an accompanying proximal fibular shaft fracture.</p><h4>Treatment</h4><p>This type of fracture always requires stabilisation of the distal <a href="/articles/distal-tibiofibular-syndesmosis">tibiofibular syndesmosis</a>, unless the patient is deemed not suitable for surgery. This is usually achieved by either screws placed across the ankle joint which are then removed after 3 months. The alternative is fibre wire construct which is placed across the ankle which need not be removed, this is often not favoured due to the cost associated with the prothesis. The associated medial malleolus fracture usually requires fixation while the proximal fibula fracture and deltoid ligament injury can be managed without surgical intervention <sup>6.</sup></p><h4>History and etymology</h4><p>It is named after <strong>Jules Germain Francois Maisonneuve</strong>, French surgeon (1809-1897) <sup>4</sup>.</p>
References changed:
- 6. Stufkens SA, van den Bekerom MP, Doornberg JN, van Dijk CN, Kloen P. Evidence-based treatment of maisonneuve fractures. (2011) The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons. 50 (1): 62-7. <a href="https://doi.org/10.1053/j.jfas.2010.08.017">doi:10.1053/j.jfas.2010.08.017</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/21172642">Pubmed</a> <span class="ref_v4"></span>
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