Can you tell us what a Maisonneuve ankle fracture is and why it has that name?
Not many people have heard of Maisonneuve injuries. The name comes from the French surgeon who first described this problem. Basically, the term refers a spiral fracture of the upper one-third of the fibula. The fibula is one of two bones in the lower leg. It is the smaller bone situated on the outside or lateral side of the leg.
People of all ages can experience a Maisonneuve injury as a result of slipping on ice, tripping and falling, falling from a height, car accidents, or sporting events. But there's more to the injury than just the fracture.
The force of the injury pushes the ankle into a flat-footed position with intense stretch pressure along the inside of the foot and ankle. The lower leg is externally (outwardly) rotated with the foot planted on the ground.
Associated injuries can also include fractures of the malleolus (bump on either side of the ankle that we usually point to and call our ankle bone) and tears or ruptures of the surrounding ankle ligaments or joint capsule.
In severe Maisonneuve injuries, the connective tissue between the two bones (tibia and fibula) is completely torn. This is called a syndesmotic disruption. Without this strong fibrous interconnecting ligament, one bone can shift up or down in relation to the other causing a difference in leg length from one leg to the other.
The goal of treatment for these injuries is to restore normal ankle alignment and movement. Surgery may not be needed for less severe Maisonneuve ankle injuries. The patient is placed in a cast for six weeks.
This approach is acceptable when there are no soft tissue injuries of ligaments, syndesmosis, or joint capsule. For more severe Maisonneuve injuries involving the syndesmosis or other soft tissues, reconstructive surgery may be required.
Bharati S. Kalyani, MD, et al. The Maisonneuve Injury: A Comprehensive Review. In Orthopedics. March 2010. Vol. 33. No. 3. Pp. 190-195.
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