Rare pattern of Maisonneuve fracture: A case report

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Background:

• Maisonneuve fracture involves proximal fibular fracture, inferior tibiofibular syndesmotic complex injury, and medial ankle structure damage.
• The Lauge-Hansen classification typically attributes Maisonneuve fractures to pronation external rotation.
• This paper presents a rare Maisonneuve fracture pattern with combined injury mechanisms.

Observation:

• A 31-year-old female presented with a complex ankle sprain initially missed by other facilities.
• Radiographs and CT scans revealed proximal fibula fracture, inferior tibiofibular joint separation, and medial malleolar fracture.
• MRI confirmed ruptures of the anterior inferior tibiofibular ligament and anterior talofibular ligament.

Findings:

• A rare Maisonneuve fracture pattern was diagnosed, incorporating proximal fibular fracture, inferior tibiofibular joint separation, medial malleolar fracture, and ligamentous ruptures.
• The injury demonstrated characteristics of both pronation external rotation and supination adduction ankle fractures.
• The patient underwent successful open reduction and internal fixation, with a good 6-month postoperative outcome.

Implications:

• This case represents a previously undescribed pattern of Maisonneuve fracture.
• The proposed injury mechanism involves a combination of supination adduction and pronation external rotation.
• Accurate analysis of complex Maisonneuve fracture mechanisms is crucial for guiding optimal clinical management and treatment strategies.