Maisonneuve fracture: Difference between revisions
| Line 30: | Line 30: | ||
==Disposition== | ==Disposition== | ||
''Depends on degree of associated ankle injury'' | ''Depends on degree of associated ankle injury'' | ||
*If splinted and stabilized, can be discharged after consultation with | *If splinted and stabilized, can be discharged after consultation with ortho<ref>J Am Acad Orthop Surg. 2007 Jun;15(6):330-9. PMID: 17548882</ref> | ||
**Will need close follow-up for likely operative repair | **Will need close follow-up for likely operative repair | ||
*Admit for:<ref>J Am Acad Orthop Surg. 2007 Jun;15(6):330-9. PMID: 17548882</ref> | *Admit for:<ref>J Am Acad Orthop Surg. 2007 Jun;15(6):330-9. PMID: 17548882</ref> | ||
**[[Open fracture]] | **[[Open fracture]] | ||
**Signs of | **Signs of neurovascular injury | ||
**Concern for [[compartment syndrome]] | **Concern for [[compartment syndrome]] | ||
Revision as of 04:57, 10 May 2019
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
Disposition
Depends on degree of associated ankle injury
- If splinted and stabilized, can be discharged after consultation with ortho[1]
- Will need close follow-up for likely operative repair
- Admit for:[2]
- Open fracture
- Signs of neurovascular injury
- Concern for compartment syndrome