We need you! Join our contributor community and become a WikEM editor through our open and transparent promotion process.
Maisonneuve fracture
From WikEM
Contents
Background
- Leg equivalent of Galeazzi fracture
Components
- Fibula fracture (anywhere from head or as far down as 6cm above ankle joint)
- Deltoid ligament rupture or medial malleolus avulsion fracture
- Injury then directed upward and laterally tearing interosseous membrane and anterior inferior tibiofibular ligament
- May involve posterior tibiofibular ligament or posterior malleolar fracture
Clinical Features
- Results from external rotation force applied to foot
Differential Diagnosis
Distal Leg Fractures
- Tibial plateau fracture
- Tibial shaft fracture
- Pilon fracture
- Maisonneuve fracture
- Tibia fracture (peds)
- Ankle fracture
- Foot and toe fractures
Evaluation
- Long leg film that includes ankle
- Increase in medial clear space of ankle joint
- Tibiofibular clear space widened >5mm
- High fibular fracture
- Signs of syndesmotic injury
Management
- Usually requires surgical intervention (sydesmotic screws; proximal fibular fracture usually requires no fixation)
- Long leg posterior splint with reduction of medial ankle and syndesmotic clear space
Disposition
See Also
References
- Wheeless CR. Maisonneuve Fracture. May 2012. http://www.wheelessonline.com/ortho/maisonneuve_fracture.
