ANALYSIS OF CLINICAL EFFECT IN SURGICAL TREATMENT OF Maisonneuve FRACTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANGZhiwen , CAIXianhua ,  WEIShijun , LIUXiming

Department of Orthopedics, Wuhan General Hospital of Guangzhou Military, Wuhan Hubei, 430070, P. R. China;

Corresponding author：

WEIShijun, Email: 455902069@qq.com

Keywords：

Ankle; Maisonneuve fracture; Internal fixation; Ligament repair

DOI：

10.7507/1002-1892.20150063

Video：

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Objective To investigate the operative method and short-term effectiveness in the surgical treatment of Maisonneuve fracture. Methods Between January 2010 and February 2013, 23 patients with Maisonneuve fracture were treated. There were 14 males and 9 females with an average age of 40.3 years (range, 30-68 years). The causes of injuries were falling injury in 11 patients, sports related injury in 5 patients, traffic accident injury in 4 patients, and falling injury from height in 3 patients. The interval between injury and operation was 7-10 days (mean, 8.5 days). All of fractures were closed. Three patients had combined injury of deltoid ligament. The surgical procedures included surgical reduction and fixation of medial malleolus fracture and posterior malleolus fracture, repair of the deltoid ligament with ground anchor suture, and fixation of the disrupted distal tibiofibular syndesmosis. Results All incisions achieved primary healing, no postoperative complications such as infection occurred. Twenty-one patients were followed up 24-36 months (mean, 26.5 months). No patients complained of pain, tenderness, and obvious swelling of the ankle. At 3-6 months (mean, 4.6 months) after operation, X-ray films showed bony union of fractures and normal mortises in 21 patients. And no traumatic arthritis was observed with reliable fixation. The range of motion of ankle dorsi flexion and plantar flexion was 30-40° (mean, 34.5°). Baird-Jackson ankle functional score was 85-100 (mean, 94); 16 cases were rated as excellent, 4 as good, and 1 as fair with an excellent and good rate of 95.2%. Conclusion Surgical treatments of Maisonneuve fracture include surgical reduction and fixation of the medial malleolus and posterior malleolus, repair of the deltoid ligament and fixation of the disrupted distal tibiofibular syndesmosis, and good effectiveness can be achieved.

Citation： ZHANGZhiwen, CAIXianhua, WEIShijun, LIUXiming. ANALYSIS OF CLINICAL EFFECT IN SURGICAL TREATMENT OF Maisonneuve FRACTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(3): 292-295. doi: 10.7507/1002-1892.20150063 Copy

1.	张银光, 贾健, 刘兆杰. Maisonneuve骨折诊治的临床特点. 中华骨科杂志, 2011, 31(7):739-743.
2.	Hinds RM, Lazaro LE, Burket JC, et al. Risk factors for posttraumatic synostosis and outcomes following operative treatment of ankle fractures. Foot Ankle Int, 2014, 35(2):141-147.
3.	冯志杰, 张辉良, 罗程, 等. Maisonneuve骨折50例临床分析. 中华实用诊断与治疗杂志, 2012, 12(26):1228-1229.
4.	Miller AN, Paul O, Boraish S, et al. Functional outcomes after syndesmotic screw fixation and removal. J Orthop Trauma, 2010, 24(1):12-16.
5.	Babis GC, Papagelopoulos PJ, Tsarouchas J, et al. Operative treatment for Maisonneuve fracture of the proximal fibula. Orthopedics, 2000, 23(7):687-690.
6.	赵文, 唐佩福, 彭海州, 等. 后踝固定治疗踝关节骨折的临床疗效. 中国修复重建外科杂志, 2010, 24(12):1432-1436.
7.	Hermans JJ, Wentink N, Beumer A, et al. Correlation between radiological assessment of acute ankle fractures and syndesmotic injury on MRI. Skeletal Radiol, 2012, 41(7):787-801.
8.	Van Seymortier P, Ryckaert A, Verdonk P, et al. Traumatic proximal tibiofibular dislocation. Am J Sports Med, 2008, 36(4):793-798.
9.	Olson SA, Glasgow RR. Acute compartment syndrome in lower extremity musculoskeletal trauma. J Am Acad Orthop Surg, 2005, 13(7):436-444.
10.	Kakel R. Maisonneuve fracture sometimes needs stress view. J Emerg Med, 2010, 42(1):65.
11.	Mitsiokapa EA, Mavrogenis AF, Antonopoulos D, et al. Common peroneal nerve palsy after grade I inversion ankle sprain. J Surg Orthop Adv, 2012, 21(4):261-265.
12.	田士松, 陈爱桂. 踝关节扭伤后致腓总神经损伤15例临床分析. 河北中医, 2013, 35(8):1267-1268.
13.	魏杰, 马春雨. 腓骨近段横形骨折合并下胫腓关节、腓总神经损伤1例. 浙江创伤外科, 2013, 18(6):938-939.
14.	张述才, 杨晶, 杨广忠, 等. 踝关节骨折切开复位内固定后下胫腓联合分离固定和未固定的疗效比较. 中国骨与关节损伤杂志, 2014, 29(10):1006-1008.
15.	吴子征, 王炳, 曹云, 等. 人工韧带修复下胫腓联合损伤的生物力学研究. 中国修复重建外科杂志, 2014, 28(10):1217-1219.
16.	Cha SD, Kim HS, Chung ST, et al. Intra-articular lesions in chronic lateral ankle instability:comparison of arthroscopy with magnetic resonance imaging findings. Clin Orthop Surg, 2012, 4(4):293-299.
17.	van den Bekerom MP, Kloen P, Luitse JS, et al. Complications of distal tibiofibular syndesmotic screw stabilization:analysis of 236 patients. J Foot Ankle Surg, 2013, 52(4):456-459.

1. 张银光, 贾健, 刘兆杰. Maisonneuve骨折诊治的临床特点. 中华骨科杂志, 2011, 31(7):739-743.
2. Hinds RM, Lazaro LE, Burket JC, et al. Risk factors for posttraumatic synostosis and outcomes following operative treatment of ankle fractures. Foot Ankle Int, 2014, 35(2):141-147.
3. 冯志杰, 张辉良, 罗程, 等. Maisonneuve骨折50例临床分析. 中华实用诊断与治疗杂志, 2012, 12(26):1228-1229.
4. Miller AN, Paul O, Boraish S, et al. Functional outcomes after syndesmotic screw fixation and removal. J Orthop Trauma, 2010, 24(1):12-16.
5. Babis GC, Papagelopoulos PJ, Tsarouchas J, et al. Operative treatment for Maisonneuve fracture of the proximal fibula. Orthopedics, 2000, 23(7):687-690.
6. 赵文, 唐佩福, 彭海州, 等. 后踝固定治疗踝关节骨折的临床疗效. 中国修复重建外科杂志, 2010, 24(12):1432-1436.
7. Hermans JJ, Wentink N, Beumer A, et al. Correlation between radiological assessment of acute ankle fractures and syndesmotic injury on MRI. Skeletal Radiol, 2012, 41(7):787-801.
8. Van Seymortier P, Ryckaert A, Verdonk P, et al. Traumatic proximal tibiofibular dislocation. Am J Sports Med, 2008, 36(4):793-798.
9. Olson SA, Glasgow RR. Acute compartment syndrome in lower extremity musculoskeletal trauma. J Am Acad Orthop Surg, 2005, 13(7):436-444.
10. Kakel R. Maisonneuve fracture sometimes needs stress view. J Emerg Med, 2010, 42(1):65.
11. Mitsiokapa EA, Mavrogenis AF, Antonopoulos D, et al. Common peroneal nerve palsy after grade I inversion ankle sprain. J Surg Orthop Adv, 2012, 21(4):261-265.
12. 田士松, 陈爱桂. 踝关节扭伤后致腓总神经损伤15例临床分析. 河北中医, 2013, 35(8):1267-1268.
13. 魏杰, 马春雨. 腓骨近段横形骨折合并下胫腓关节、腓总神经损伤1例. 浙江创伤外科, 2013, 18(6):938-939.
14. 张述才, 杨晶, 杨广忠, 等. 踝关节骨折切开复位内固定后下胫腓联合分离固定和未固定的疗效比较. 中国骨与关节损伤杂志, 2014, 29(10):1006-1008.
15. 吴子征, 王炳, 曹云, 等. 人工韧带修复下胫腓联合损伤的生物力学研究. 中国修复重建外科杂志, 2014, 28(10):1217-1219.
16. Cha SD, Kim HS, Chung ST, et al. Intra-articular lesions in chronic lateral ankle instability:comparison of arthroscopy with magnetic resonance imaging findings. Clin Orthop Surg, 2012, 4(4):293-299.
17. van den Bekerom MP, Kloen P, Luitse JS, et al. Complications of distal tibiofibular syndesmotic screw stabilization:analysis of 236 patients. J Foot Ankle Surg, 2013, 52(4):456-459.

Chinese Journal of Reparative and Reconstructive Surgery

ANALYSIS OF CLINICAL EFFECT IN SURGICAL TREATMENT OF Maisonneuve FRACTURE

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