Biplane Reduction: A Novel Technique for Restoring Fibula Length in Maisonneuve Fracture

Fibular length is important for ankle stability. Failure to adequately restore and stabilize fibula length may result in malunion, hindering postoperative functional exercises and recovery of ankle function. However, there is no unified and effective reduction method for fibular shortening in Maisonneuve fractures. In this study, we introduce the biplane reduction as an effective surgical technique for restoring the length of the fibula in Maisonneuve fractures.

This retrospective study enrolled 12 patients preoperatively diagnosed with Maisonneuve fractures between June 2019 and June 2022. All patients underwent our biplane reduction technique to restore the length of their fibula. Operation time, hospital stay, complications, FTA (the angle between the fibular tip and the superior articular surface of the talus), visual analog pain score, and the American Orthopaedic Foot and Ankle Society ankle-hindfoot score were recorded. An independent sample t-test was used for component comparisons, and a paired sample t-test or one-way analysis of variance was used for intra-group comparisons.

No patient was lost to follow-up and no obvious postoperative complications were observed. After operation, FTA recovered from 37.52 ± 0.37 ° to 40.42 ± 0.43 °, which was significantly improved compared with that before operation (p < 0.01). At the last follow-up, both the VAS and AOFAS scores showed significant improvement compared to pre-surgery scores.

The reduction technique proposed in this study to restore the length of the fibula in Maisonneuve fractures is simple and effective, does not require special equipment, and has the advantage of directly examining the reduction condition.