Maisonneuve fracture: Difference between revisions
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==Evaluation== | ==Evaluation== | ||
*Assess distal pulse, motor, and sensation | |||
*Inspect skin for signs of open fracture | |||
*Long leg film that includes ankle | *Long leg film that includes ankle | ||
**Increase in medial clear space of ankle joint | **Increase in medial clear space of ankle joint | ||
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==Management== | ==Management== | ||
*Usually requires surgical intervention ( | *Usually requires surgical intervention (syndesmotic screws; proximal fibular fracture usually requires no fixation) | ||
*[[Long leg posterior splint]] with reduction of medial ankle and syndesmotic clear space | *[[Long leg posterior splint]] with reduction of medial ankle and syndesmotic clear space | ||
Revision as of 17:00, 14 March 2018
Background
- Lower extremity 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
- Foot and toe fractures
Evaluation
- Assess distal pulse, motor, and sensation
- Inspect skin for signs of open fracture
- 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
Management
- Usually requires surgical intervention (syndesmotic screws; proximal fibular fracture usually requires no fixation)
- Long leg posterior splint with reduction of medial ankle and syndesmotic clear space