[Possible nerve injuries in ankle dislocations. Trimalleolar fracture including the proximal fibula]

We present a patient with an exceptional fracture type--a Maisonneuve fracture associated with a lateral ankle fracture--and the therapy of this injury. The Maisonneuve fracture consists of a proximal fibular fracture which is associated with failure of the deltoid ligament or medial malleolus and diastasis of the distal tibiofibular syndesmosis. Diverse nerves of the lower leg can be affected by severe trauma as well as by fracture-associated complications or an operation. Fracture fragments, an excessive distension caused by the trauma, or a fracture-associated hematoma can cause injury to the deep peroneal nerve or the branches of the superficial peroneal nerve at the level of the ankle. We want to point out the possibility of nerve lesions of the lower leg associated with this complex fracture. Additionally the operative access to the ankle in this context is discussed.