Maisonneuve fracture

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 Fracture Types

• Tibial plateau fracture
• Tibial shaft fracture
• Pilon fracture
• Maisonneuve fracture
• Tibia fracture (peds)
• Ankle fracture
  • Ankle fracture (peds)
    • Tillaux fracture
• Foot and toe fractures

Diagnosis

• 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

Maisonneuve fracture

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

See Also

• Distal leg fractures

References

• Wheeless CR. Maisonneuve Fracture. May 2012. http://www.wheelessonline.com/ortho/maisonneuve_fracture.