Maisonneuve Fracture without Deltoid Ligament Disruption: A Rare Pattern of Injury

Charopoulos, Ioannis; Kokoroghiannis, Constantine; Karagiannis, Spyridon; Lyritis, George P.; Παπαϊωάννου, Νικόλαος

doi:10.1053/j.jfas.2009.10.001

Cited by 11 publications

(20 citation statements)

References 16 publications

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“…One case (1/41, 2.44%) had intact medial structures, complete rupture of AITFL, proximal fibular fracture, and posterior malleolar fracture. In spite of the fact that the imaging findings were atypical, we classified this case as supination external rotation mechanism 11–13 .…”

Section: Resultsmentioning

confidence: 99%

“…Previous studies 5,13,21 suggested that the force of external rotation led to the rupture of the interosseous ligament and the conduction of the force along the IOM to the proximal end led to fibular fracture and rupture of the IOM to the level of the fibular fracture. Manyi et al 8 found that all 12 patients with Maisonneuve fractures had the injury of the IOM, but only limited to the distal one-third of the calf and no more than 112 mm to the proximal ankle level.…”

Section: Injury Of the Inferior Tibiofibular Ligamentmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 98%

“…Previous studies reported that the medial structure remained intact without rupture of the deltoid ligament or fracture of the medial malleolus in the case of Maisonneuve fracture, suggesting that supination–external rotation could also lead to Maisonneuve fracture 11–13 . For example, Charopoulos et al 13 . reported a case of atypical Maisonneuve fracture, which was confirmed by X‐ray and magnetic resonance imaging (MRI) examinations as: fracture of the fibular neck; fracture of the posterior malleolus; and partial rupture of the AITFL and anterior talofibular ligament, without rupture of the deltoid ligament and fracture of the medial malleolus.…”

Section: Introductionmentioning

confidence: 99%

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Pathoanatomy and Injury Mechanism of Typical Maisonneuve Fracture

Xin

et al. 2020

Orthopaedic Surgery

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Objective: Maisonneuve fracture is a special type of injury which are rare in clinic. The manifestation of such fractures is variable. The aim of this study is to describe the pathoanatomical features of typical Maisonneuve fracture on the basis of radiographs, computed tomography (CT) scans, magnetic resonance imaging (MRI), and intraoperative exploration findings, and to investigate the injury mechanism of this variety. Methods: The data of 41 patients with Maisonneuve fracture from April 2014 to September 2019 were retrospectively analyzed. There were 32 males and nine females, the average age was 37.9 years (range, 18 to 61 years), the fractures occurred on the left side in 20 patients and on the right side in 21 patients. The cause of injuries were traffic accident in five patients, sprain injury in 20 patients, and falling injury from height in 16 patients. All patients underwent posteroanterior and lateral X-ray examinations of the ankle and calf. CT scan of the ankle was performed in 38 patients, including three-dimensional reconstruction in 33 patients. MRI examination of the ankle and calf was performed in 28 and five patients, respectively. Forty patients were treated with open reduction and internal fixation. The features of proximal fibular fracture, injuries of the medial and posterior structures of the ankle, injuries of the anterior inferior tibiofibular ligament and the interosseous membrane were recorded and analyzed. Results: Forty-one patients had proximal one-third fractures of the fibula including six patients with fracture involving the fibular neck, 30 with proximal one-third fractures of the fibular shaft, and five with proximal-medial one-third junction fracture of the fibular shaft. Thirty-five patients (35/41, 85.37%) with injury of posterior structures, 34 patients had posterior malleolar fracture (34/41, 82.93%), and one patient had posterior inferior tibiofibular ligament rupture (1/41, 2.44%). There were 20 patients with type I fracture, four patients with type II fracture, and 10 patients with type III fracture according to the Haraguchi classification of posterior malleolus fracture. The fracture of the medial malleolus was in 30 patients (30/41, 73.17%), rupture of the deltoid ligament was in 10 patients (10/41, 24.39%), and medial structures intact were in one patient (1/41, 2.44%). All 41 patients had injury of the anterior inferior tibiofibular ligament. Conclusions: Maisonneuve fracture is characterized by fractures of the proximal fibula and the complete rupture of the anterior inferior tibiofibular ligament. Pronation-external rotation is the main injury mechanism. The manifestations of typical Maisonneuve fracture including that the fibular fracture located in proximal one-third diaphysis and the fracture line was from anterosuperior to posteroinferior.

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Section: Resultsmentioning

confidence: 99%

Section: Injury Of the Inferior Tibiofibular Ligamentmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Pathoanatomy and Injury Mechanism of Typical Maisonneuve Fracture

Xin

et al. 2020

Orthopaedic Surgery

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“…Madhusudhan et al 7 described a Maisonneuve fracture with an associated fracture of the distal lateral tibial plafond, intact syndesmotic ligaments, and an intact deltoid ligament. Charopoulos et al 8 described a Maisonneuve fracture without medial ankle injury that was successfully treated nonoperatively. Healy et al 9 fractures for which MRI showed an intact posterior inferior tibiofibular ligament attached to the posterolateral fragment.…”

Section: Discussionmentioning

confidence: 99%

Maisonneuve-Hyperplantarflexion Variant Ankle Fracture

Hinds¹,

Tran²,

Lorich³

2014

Orthopedics

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Maisonneuve fractures are rare ankle injuries, accounting for up to 7% of all ankle fractures. They consist of a proximal third fibula fracture, syndesmotic disruption, and medial ankle injury (either a deltoid ligament disruption or a medial malleolus fracture), and are often successfully managed with nonoperative treatment of the proximal fibula fracture and open reduction and internal fixation (ORIF) of the medial ankle injury and syndesmotic disruption. The hyperplantarflexion variant ankle fracture comprises approximately 7% of all ankle fractures and features dual posterior tibial lip fractures featuring a posterolateral fragment and a posteromedial fragment. Good functional results have been reported in the literature after ORIF of both the posterolateral and posteromedial fragments of this variant fracture that is not described by the Lauge-Hansen classification. In this report, the authors present the unique case of an isolated ankle fracture demonstrating characteristics of both a Maisonneuve fracture and a hyperplantarflexion variant ankle fracture. They also highlight the diagnostic imaging characteristics, including magnetic resonance imaging (MRI) and preoperative radiograph findings, surgical treatment, and postoperative clinical outcome for this patient with a Maisonneuve-hyperplantarflexion variant ankle fracture. To the authors' knowledge, this unique fracture pattern has not been reported previously in the literature. The authors conclude that although good results were seen postoperatively in this case, the importance of ORIF of both the posteromedial and posterolateral fragments of variant fractures cannot be overstated. They also found MRI to be a particularly helpful adjunct in formulating the correct diagnosis and treatment plan.

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Tibia and Fibula

Denq

2020

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Maisonneuve Fracture without Deltoid Ligament Disruption: A Rare Pattern of Injury

Cited by 11 publications

References 16 publications

Pathoanatomy and Injury Mechanism of Typical Maisonneuve Fracture

Pathoanatomy and Injury Mechanism of Typical Maisonneuve Fracture

Maisonneuve-Hyperplantarflexion Variant Ankle Fracture

Tibia and Fibula

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