Maisonneuve fracture: Difference between revisions
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==Management== | ==Management== | ||
*[[Long leg posterior splint]] with reduction of medial ankle and syndesmotic clear space | *[[Long leg posterior splint]] with reduction of medial ankle and syndesmotic clear space | ||
==Disposition== | ==Disposition== | ||
''Depends on degree of associated ankle injury'' | |||
*If splinted and stabilized, can be discharged after consultation with | *If splinted and stabilized, can be discharged after consultation with ortho<ref>J Am Acad Orthop Surg. 2007 Jun;15(6):330-9. PMID: 17548882</ref> | ||
**Will need close follow-up for likely operative repair | **Will need close follow-up for likely operative repair | ||
*Admit for: | *Admit for:<ref>J Am Acad Orthop Surg. 2007 Jun;15(6):330-9. PMID: 17548882</ref> | ||
**Open fracture | **[[Open fracture]] | ||
**Signs of neurovascular injury | **Signs of neurovascular injury | ||
**Concern for compartment syndrome | **Concern for [[compartment syndrome]] | ||
===Specialty Management=== | |||
*Usually requires surgical intervention (syndesmotic screws; proximal fibular fracture usually requires no fixation) | |||
==See Also== | ==See Also== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
Revision as of 04:58, 10 May 2019
Background
- Lower extremity 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 Fracture Types
- Tibial plateau fracture
- Tibial shaft fracture
- Pilon fracture
- Maisonneuve fracture
- Tibia fracture (peds)
- Ankle fracture
- Foot and toe fractures
Evaluation
- Assess distal pulse, motor, and sensation
- Inspect skin for signs of open fracture
- 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
- Long leg posterior splint with reduction of medial ankle and syndesmotic clear space
Disposition
Depends on degree of associated ankle injury
- If splinted and stabilized, can be discharged after consultation with ortho[1]
- Will need close follow-up for likely operative repair
- Admit for:[2]
- Open fracture
- Signs of neurovascular injury
- Concern for compartment syndrome
Specialty Management
- Usually requires surgical intervention (syndesmotic screws; proximal fibular fracture usually requires no fixation)