A 72-Year-Old Patient with Bilateral Maisonneuve Fractures

Abstract

Maisonneuve fractures result from a disruption of the medial ankle structures and a proximal fibular fracture. Patient complaints can be misleading and there is a significant rate of delayed diagnosed injuries. We present a case of bilateral Maisonneuve fractures after a fall due to a syncopal collapse. A precise clinical examination led to this rare diagnosis. The injuries were treated with syndesmotic screw fixation, removal of hardware followed after 6 weeks. The patient was asymptomatic at three-months follow up. Patients with bilateral injuries undergoing standard surgical treatment can gain full recovery, but high suspicion in clinical examination is needed to detect this uncommon bilateral injury.

Maisonneuve Fractures of the Ankle

“…MFs account for 3.5% to 7.0% of all ankle fractures 9,27,29,37,46 . Bilateral occurrence is very rare 23 . The male-female ratio and the mean patient age vary among studies (Table I).…”

“…In 2019, Bartoníček et al described the pathoanatomy of 54 MFs in detail; 3D computed tomography (CT) reconstructions were available for 34 cases 11 . The number of reported MFs is gradually increasing, mostly in the form of case reports [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] , with only a few studies including larger series [27][28][29][30][31][32][33][34][35][36] . Meanwhile, the term "Maisonneuve fracture" is Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/A804).…”

“…In 2019, Bartoníček et al described the pathoanatomy of 54 MFs in detail; 3D computed tomography (CT) reconstructions were available for 34 cases 11 . The number of reported MFs is gradually increasing, mostly in the form of case reports 12-26 , with only a few studies including larger series 27-36 . Meanwhile, the term “Maisonneuve fracture” is associated with many different interpretations by individual authors 37-39 .…”

Bilateral simultaneous rotational ankle fractures: case series and literature review

“…16 There were only 6 separate cases reported in literature that are similar to our cases in being bilateral rotational type ankle injuries with some of them being identical. [10][11][12][13][14][15] Majority of the cases along with ours, were in fact as result of relatively high mechanism trauma and were associated with rotational injury patterns. This is unexpected especially when the energy absorbed caused symmetrical rotational injuries in contrast to axial type ankle fractures that commonly present as a result of high mechanism trauma.…”

“…8,9 Twisting mechanism can lead to multiple variety of injuries such as; Maisonneuve fracture, Tillaux fracture, or Lauge-Hansen classified ankle fractures, of which have been separately reported in literature to present bilaterally. [10][11][12][13][14][15] In this study, we present rare cases of simultaneous bilateral rotational fractures and reviewed similar cases presented in literature and discused the etiological mechanism of the injuries sustained and their presentation.…”