Presentation
Slipped on an oil slick and twisted his leg, complains of pain from knee downward.
Patient Data
Age: 55 years
Gender: Male
From the case:
Maisonneuve fracture
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Mildly displaced distal tibial metaphyseal spiral fracture. From it, a nondisplaced vertical fracture line runs inferiorly to the tibial plafond (seen on lateral X-ray).
Proximal fibular metaphyseal fracture.
Together, these represent a Maisonneuve fracture.
From the case:
Maisonneuve fracture
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The calf and the ankle are placed in a temporary plaster cast.
There is a proximal metaphyseal fibular fracture.
There is a distal mildly displaced tibial metaphyseal spiral fracture and a vertical fracture extending from it to the plafond.
From the case:
Maisonneuve fracture
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External fixation in plaster cast.
Case Discussion
Once you have identified a distal tibial fracture, always look for an accompanying fibular fracture.