The Maisonneuve fracture with medial and posterior malleolar fractures: A case report

Abstract

Introduction: Maisonneuve’s fracture is named after the French surgeon who first described it in 1840. This injury is rare and is characterized by a combination of a fracture of the ipsilateral fibula and an injury to the medial structures of the ankle, and there may also be a rupture of the syndesmosis, tibiofibular and deltoid ligament, followed by rupture of the anteroinferior tibiofibular ligament and rupture of the interosseous ligament and interosseous membrane. Case Report: A 70-year-old female patient reported pain in the right lower limb. Clinical examination, after excluding possible fractures associated with age group, revealed hematoma on the ankle, edema on the topography of the right lateral malleolus and on the lateral aspect of the right knee. Radiographs revealed lateral subluxation of the right ankle, increased medial free space associated with fracture of the medial malleolus, fracture of the posterior malleolus, and proximal fracture of the ipsilateral fibula. The patient was admitted for urgent orthopedic surgery. Lateral access distal to the fibula was used in the distal fibulotibial joint, anatomical reduction of the ankle with reduction forceps and placement of a 3.5 mm third-barrel plate and two 3.5 mm cortical screws with sizes of 50 and 45 mm under fluoroscopy. Conclusion: A Maisonneuve fracture is an orthopedic emergency that needs to be identified quickly because it usually requires surgery. Surgery must be well planned and requires an adequate postoperative period to rehabilitate the patient to avoid sequelae such as early osteoarthrosis and chronic pain.