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Maisonneuve Fracture, MedPix™ : 6626 - Medical Image Database and Atlas
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More Like This ? Maisonneuve Fracture
Topic ID: 6626 - Modified: 2006-02-15 16:22:47.979617-05 - Created: 2005-07-21 04:47:49-04
ACR Index: 4.4

Maissoneuve's fracture was described by a French surgeon in 1840 and corresponds to the Lauge-Hansen pronation-external rotation mechanism of ankle injury. The fracture is unstable, but this can be underestimated by plain film. With the ankle in pronation and application of the external rotation force, the fibroosseous ring formed by the talus, medial/lateral malleoli, collateral ligaments, and distal tibiofibular syndesmosis is disrupted in a sequential manner. Stress on the deltoid ligament and posterior tibiofibular ligaments causes either ligamentous disruption or avulsion fractures of the medial and "posterior" malleoli repectively. The injury then disrupts the anterior tibiofibular ligament and the force continues up and disrupts the distal syndesmosis and interosseous ligament. The fibula fractures proximally as an extension of the ascending force. The inherent lateral instablity of this injury can be underestimated by plain films, which can often reflect a seemingly intact fibroosseous ring about the ankle. Treatment usually requires internal fixation at the level of the distal syndesmosis.

A Maisonneuve fracture should be considered in the case of the seemingly isolated posterior malleolar fracture, and complete evaluation of the tibia, fibula and syndesmosis is needed.

Topic Contributor Credits

Topic Submitted by: Erik S Storm - Author Info
Affiliation: Uniformed Services University
Topic approved by: Lorraine G. Shapeero, M.D. - Editor Info
Affiliation: Uniformed Services University

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