Case Report


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

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1 Post-Graduate student in Sports Medicine, Iguaçu University, Nova Iguaçu/Rio de Janeiro, Brazil

2 Medical student, Iguaçu University - UNIG/RJ, Nova Iguaçu - RJ, Brazil

3 Physician, Neurologist, Adjunct Professor of Medicine at Universidade Iguaçu, Iguaçu University - UNIG/Nova Iguaçu, RJ, Brazil

4 Department of Neurology of Hospital Geral de Nova Iguaçu, Adjunct Professor of Medicine at Iguaçu University - UNIG/Nova Iguaçu, RJ, Brazil

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Antônio Marcos da Silva Catharino

Rua Gavião Peixoto 70, Room 811, CEP 24.2230-100, Icaraí, Niterói-RJ,

Brazil

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Article ID: 101385Z01JG2023

doi: 10.5348/101385Z01JG2023CR

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How to cite this article

De Souza Nóia Gonçalves JG, Pereira DA, Amaral AB, Marano BP, Orsini M, da Silva Catharino AM. The Maisonneuve fracture with medial and posterior malleolar fractures: A case report. Int J Case Rep Images 2023;14(1):66–69.

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.

Keywords: Maisonneuve fracture, Malleolar fracture, Osteoarthrosis

SUPPORTING INFORMATION


Author Contributions

José Guilherme De Souza Nóia Gonçalves - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Daniel Antunes Pereira - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published

Arthur Bomfim Amaral - Substantial contributions to conception and design, Interpretation of data, Drafting the article, Final approval of the version to be published

Bruno Povoleri Marano - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Marco Orsin - Substantial contributions to conception and design, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Antônio Marcos da Silva Catharino - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Guarantor of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2023 José Guilherme De Souza Nóia Gonçalves et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.