“Floating Fibula” Secondary to Traumatic Dislocation of the Ankle Joint, Ankle Syndesmosis, and the Proximal Tibiofibular Joint

Hey, Hwee Weng Dennis; Lau, Bernard Puang Huh; Thambiah, Joseph; Khong, K S; Murphy, Diarmuid

doi:10.2106/jbjs.cc.m.00028

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…Maisonneuve originally described a “subcapital fracture of the fibula associated with rupture of the anterior tibiofibular ligament.” 1 Some authors have extended this term to all fractures of the middle third or the proximal half of the fibula 15,21,26 . Others speak of “Maisonneuve-like” fractures in cases with an intact fibula (so-called “sprains of the tibiofibular joint”), with or without dislocation of the fibular head in the proximal tibiofibular joint 40-45 . Based on the analyses that have been published to date, an MF may be best defined as a fracture of the proximal quarter of the fibula that is combined, at least, with rupture of the anterior tibiofibular ligament (ATFL) and the interosseous tibiofibular ligament.…”

Section: Definitionmentioning

confidence: 99%

Maisonneuve Fractures of the Ankle

2022

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Maisonneuve fractures (MFs), originally described as subcapital (high) fibular fractures with additional injury to the anterior and interosseous tibiofibular ligaments, display a variable injury pattern, ranging from stable to highly unstable fractures.The high incidence of associated fractures of the posterior malleolus, the medial malleolus, and the anterolateral distal tibia (the “anterior malleolus”) as well as the variable position of the fibula in the fibular notch (FN) warrant preoperative examination via computed tomography (CT).The main goal of treatment is anatomic reduction of the distal fibula into the FN, which requires prior reduction of displaced posterior malleolar fractures, if present, to restore the integrity of the FN.Open reduction of the distal fibula into the FN and fixation with 2 transsyndesmotic screws or fixation with a screw(s) and suture-button implant, under direct vision, on the lateral aspect of the ankle joint and anterior tibiofibular alignment are preferred over closed reduction to avoid sagittal or rotational malpositioning, which is associated with an inferior outcome.Intra- or postoperative 3D CT visualization is essential for assessment of the accuracy of the reduction of the distal fibula into the FN.

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Section: Definitionmentioning

confidence: 99%

Maisonneuve Fractures of the Ankle

2022

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“…The most injured bones could [19], the firth metacarpal [20], the second metacarpal [21], the third metacarpal [22], the fourth metacarpal [35], the fifth metatarsal [35], the isolated ulna [23], the fibula [24], the first phalanx [25], the second phalanx [26], etc. The second group with a freed group of bones includes the forearm (radius-ulna complex [27] [28] or radius-ulna-lunatum complex [15] [29] and the leg (tibia-fibula-talus complex) [30].…”

Section: Epidemiologymentioning

confidence: 99%

Traumatic Floating Bone. About 11 Cases and a Literature Review

Kasse¹,

Diallo²,

Diao³

et al. 2017

OJO

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Introduction: Floating bone injury or bipolar dislocation is a concurrent dislocation at both ends of a long bone or a flat bone. It is an exceptional injury. We report 11 consecutives cases of floating bones. Objectives: The aim of the study is to analyze the frequency, the mechanism of injury and clinical forms of floating bones, and to present the results of their management. Material and Methods: A ten years ongoing retrospective study was held in four trauma departments. Eleven cases of floating bones were identified. The floating bones characteristics such as the injured bone, the patient age and sex, the mechanism of injury, the dislocations directions, the associated complications, the treatment and the outcome were studied. Results: Nine male and two female patients, with a mean age of 37 years [19 -65 years range] presented a concurrent bipolar dislocation of one bone or a group of bones. They sustained a road traffic accident (n = 5), a workplace accident (n = 3), a fall from height (n = 2), and a sport accident (n = 1). The clavicle (n = 3) and the first metatarsal (n = 3) were the most frequently involved. The others floating bones were the radius-ulna complex (n = 1), the radius-lunatum complex (n = 1), the first metacarpal (n = 1), the first phalanx (n = 1) and the femur (n = 1). The floating bones ends displacement occurred in the sagittal plane (the forearm, the femur, the first phalanx and the first metatarsal) and in the horizontal plane (the clavicle, the first metatarsal and the first metacarpal). We defined direction displacements as bidirectional asymmetric (n = 10) or unidirectional symmetric (n = 1). Associated complications were fractures (wrist, hip, tarso-metatarsal joints) and wounds (fingers, metatarso-phalangeal joint). Dislocations were treated conservatively (n = 5) and surgically (n = 17) with excellent results (n = 13/16 joints). Three patients were lost of view. Conclusion: Our study described the characteristics of How to cite this paper: Kasse, A.N.,

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“…There are few reports of floating fibula injuries in the literature. Hey et al 1 reported a single case of an open ankle dislocation with clear disruptions of the syndesmosis and PTFJ. Levy et al 2 reported a single case of a floating fibula in a closed ankle injury without an ankle dislocation.…”

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Treatment and Outcome of a “Floating Fibula” Injury

Joseph

Morgan

Mutty

2023

JBJS Case Connector

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Case:We report a case of a rare “floating fibula” ankle injury characterized by dislocation of the proximal tibiofibular joint (PTFJ), syndesmosis disruption, complete deltoid disruption, and tibiotalar dislocation without fibula fracture in a 44-year-old man. Imaging includes preoperative and postoperative radiographs and CT scans. Treatment involved reduction and screw fixation of the syndesmosis and PTFJ with planned screw removal. A successful clinical and radiographic outcome was achieved at the 15-month follow-up.Conclusion:This case highlights the unique features of the “floating fibula” injury and shows that reduction and intraoperative assessment may be more challenging than a typical Maisonneuve injury.

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“Floating Fibula” Secondary to Traumatic Dislocation of the Ankle Joint, Ankle Syndesmosis, and the Proximal Tibiofibular Joint

Cited by 4 publications

References 4 publications

Maisonneuve Fractures of the Ankle

Maisonneuve Fractures of the Ankle

Traumatic Floating Bone. About 11 Cases and a Literature Review

Treatment and Outcome of a “Floating Fibula” Injury

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