Maisonneuve Fracture

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.

Causes

One cause of ankle injury is previous injury; inadequately rehabilitated ankle sprains place the ankle at risk for subsequent injuries. The use of narrow cleats with minimal arch support or the use of running shoes for a court sport also can place an athlete at risk for ankle sprains.

Signs

• Tenderness at medial malleolus and proximal fibula

Treatment

These types of fractures result in a open reduction with internal fixation. The orthopaedic surgeon will reduce the fracture anatomically and use plates and screws to fix the reduction. The fluoroscopic picture at the bottom of the page shows the result of an ORIF of a medial malleolar and tibial shaft fractures and a syndesmosis disruption. The horizontal screw holding the tibia and fibula together will allow the syndesmosis to heal.

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 by the physician to restore normal strength, range of motion, and proprioception.