isolated medial malleolus fracture; isolated lateral malleolus fracture full-length tibia, or proximal tibia, to rule out Maisonneuve-type fracture. of the lower extremity were ordered and they demonstrate a high fibular fracture, i.e. Weber C stage 3 also known as a Maisonneuve fracture. Triplane fracture; Maisonneuve fracture; Tillaux fracture. juvenile Tillaux. Publicationdate October 1, The ankle is the most frequently injured joint.

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The lateral malleolus is fracturz off’ from anterior to posterior. Partial weight bearing starting 1 week after the trauma. Final report Weber C stage 4, i. What we normally see is a stage 2 oblique fracture through the syndesmosis and we have to assume that there is also a rupture of the anterior tibiofibular ligament, which is stage 1.

This fracture is named triplane because it occurs in the coronal, sagittal and axial plane. Views Read Edit View history. Lateral Xray of ankle showing fractures NB proximal fibula fracture not shown. Cervical fracture Jefferson fracture Hangman’s fracture Flexion teardrop fracture Clay-shoveler fracture Burst fracture Compression maisonneuvs Chance fracture Holdsworth fracture. This is always above the level of the syndesmosis.

Classification The fracture starts at the level of the ankle joint and extends proximally, i. Type V growth plate fractures carry the most concerning prognosis as bone alignment and length can be affected. Ed ligamentous rupture has it’s avulsion fracture counterpart.

Maisonneuve fracture – Wikipedia

On the lateral view a small tertius fragment is seen indicating stage 3. This is an unstable fracture with dislocation that needs surgical repair. The fracture through the growth plate is only seen on CT. It occurs before the distal tibial epiphysis has completely fused.


Avulsion fracture of the medial malleolar. This type of injury can be difficult to detect. In many cases there is only minimal or no displacement. Once you understand the trauma mechanism as described by Lauge-Hansen and the sequence of events that take dractura in stages, then you know where to look for fractures and ligamentous injuries.

Here we have images of an extremely difficult case. Epiphyseal fracture in the sagittal plane Injury to the growth plate in the axial plane Metaphyseal fracture in the coronal plane. A fracture of the posterior malleolus as an isolated finding is very uncommon. It is a transverse fracture through the cartilage of the growth plate or physis. First impression We can exclude a Weber A or B fracture, because we see no fracture.

This should make you consider a tertius fracture.

Ankle – Special fracture cases

maisonneue At reexamination you notice the subtle avulsion of the medial malleolus red arrowwhich is stage 1. Stage 4 Finally the posterior syndesmotic ligament ruptures, or there is an avulsion of the posterior malleolus, also known as posterior malleolus fracture red arrow.

Here a more subtle case. This patient has an unstable ankle injury and a syndesmotic screw needs to be inserted. Study the images and then continue reading.

Isolated fracture of maisinneuve medial malleolus Isolated fracture of the posterior malleolus without a fracture on the lateral side Any painful swelling or hematoma on the medial side without a fracture on the radiographs. Infobox medical condition new All stub articles. Weber classified them as: A posterior malleolus fracture as an isolated finding is very uncommon. Although the patient is already in a cast you order additional films to look for a possible stage 3. Another Tillaux in a patient with a strange combination of findings.


So at second look you notice a subtle widening of the lateral clear space on the original films, which could indicate but is definitely no proof of a syndesmotic rupture. Final report Trimalleolar fracture. First study the images and then continue reading.

Avulsion fracture Chalkstick fracture Greenstick maisonnneuve Open fracture Pathologic fracture Spiral fracture. Which of the following could have prevented this patient from developing persistent pain?

According to Lauge-Hansen, it is the result of an adduction force on the supinated foot. Rib fracture Sternal d. On the AP-view there is a lucency within the epiphysis, which is the epiphyseal fracture in the sagittal plane.

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After this re-examination you can make a final report. Radiographs from the ER are provided in figures A and B.

The Frenchman’s fibular fracture (Maisonneuve fracture).

It is a high Weber C fracture. Please vote below and help us build the most advanced adaptive learning platform in medicine. The Lauge-Hansen classification will give you the fracture mechanism and the preliminary stage of the ankle injury.

This is stage 2 and we have to assume, that the anterior syndesmosis is ruptured. A syndesmotic screw has to be inserted.