Maisonneuve fracture is a disruption-bony or ligamentous- of the medial ankle and proximal fibula and is usually caused by external rotation of the ankle. There is an associated fracture of the medial malleolus or rupture of the deep deltoid ligament. This type of injury can be difficult to detect.
Maisonneuve fractures and syndesmosis injuries occur most often in athletes. The foot is planted on the ground and the lower leg rotates around it. The force of the injury is translated through the interosseus membrane, travels up the leg, and exits through the top of the bone. The result is a proximal fibular fracture.
With a Maisonneuve fracture, there can even be a fracture of the tibia at the bottom near the ankle. One cause of ankle injury is previous injury; inadequately rehabilitated ankle sprains place the ankle at risk for subsequent injuries. Common sign of maisonneuve fracture is tenderness at medial malleolus and proximal fibula.
Maisonneuve fracture need to reaaproximate syndesmosis.The syndesmosis screw will have to be removed in a subsequent surgery. If not removed, the screw's presence will not allow for normal ankle motion and could break causing more pain. Rehabilitation should proceed as directed.
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