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.	張銀光, 賈健, 劉兆杰. Maisonneuve骨折診治的臨床特點. 中華骨科雜志, 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.	馮志杰, 張輝良, 羅程, 等. Maisonneuve骨折50例臨床分析. 中華實用診斷與治療雜志, 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.	趙文, 唐佩福, 彭海州, 等. 后踝固定治療踝關節骨折的臨床療效. 中國修復重建外科雜志, 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, 陳愛桂. 踝關節扭傷后致腓總神經損傷15例臨床分析. 河北中醫, 2013, 35(8):1267-1268.
13.	魏杰, 馬春雨. 腓骨近段橫形骨折合并下脛腓關節、腓總神經損傷1例. 浙江創傷外科, 2013, 18(6):938-939.
14.	張述才, 楊晶, 楊廣忠, 等. 踝關節骨折切開復位內固定后下脛腓聯合分離固定和未固定的療效比較. 中國骨與關節損傷雜志, 2014, 29(10):1006-1008.
15.	吳子征, 王炳, 曹云, 等. 人工韌帶修復下脛腓聯合損傷的生物力學研究. 中國修復重建外科雜志, 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. 張銀光, 賈健, 劉兆杰. Maisonneuve骨折診治的臨床特點. 中華骨科雜志, 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. 馮志杰, 張輝良, 羅程, 等. Maisonneuve骨折50例臨床分析. 中華實用診斷與治療雜志, 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. 趙文, 唐佩福, 彭海州, 等. 后踝固定治療踝關節骨折的臨床療效. 中國修復重建外科雜志, 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, 陳愛桂. 踝關節扭傷后致腓總神經損傷15例臨床分析. 河北中醫, 2013, 35(8):1267-1268.
13. 魏杰, 馬春雨. 腓骨近段橫形骨折合并下脛腓關節、腓總神經損傷1例. 浙江創傷外科, 2013, 18(6):938-939.
14. 張述才, 楊晶, 楊廣忠, 等. 踝關節骨折切開復位內固定后下脛腓聯合分離固定和未固定的療效比較. 中國骨與關節損傷雜志, 2014, 29(10):1006-1008.
15. 吳子征, 王炳, 曹云, 等. 人工韌帶修復下脛腓聯合損傷的生物力學研究. 中國修復重建外科雜志, 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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