isolated medial malleolus fracture; isolated lateral malleolus fracture full-length tibia, or proximal tibia, to rule out Maisonneuve-type fracture. of the lower extremity were ordered and they demonstrate a high fibular fracture, i.e. Weber C stage 3 also known as a Maisonneuve fracture. Triplane fracture; Maisonneuve fracture; Tillaux fracture. juvenile Tillaux. Publicationdate October 1, The ankle is the most frequently injured joint.
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External rotation injury of the ankle is the most common ankle injury and can lead fratura a Weber B or Weber C fracture. This tertius fracture can also be seen on the lateral view, maisonneuvve in many cases we need all the information of both the lateral and AP-view to diagnose a tertius fracture. Weber C This is a fracture above the level of the syndesmosis.
She progressed well until 2 months ago when she notes heel deformity and ankle swelling. This woman had a distortion of the ankle and had pain on both medial and lateral side. Notice that the epiphyseal fracture is in the sagittal plane, the fracture through the growth plate is in the axial plane and the metaphyseal fracture is in the coronal plane. Notice the horizontal orientation of the lateral malleolus fracture and the vertical orientation of the fracture of the medial malleolus.
Diagnosis, Reduction, and Fixatio In stage 2 the talus exorotates further and since the foot is in supination, the lateral malleolus is held tightly in place by the lateral collateral ligaments. Continuous force will twist the fibula and displace it distally, while proximally it is fixed to the tibia. At surgery the ankle was found to be unstable and syndesmosis screws were inserted.
At reexamination you notice the subtle avulsion of the medial malleolus red arrowwhich is stage 1.
Type V growth plate fractures carry the most concerning prognosis as bone alignment and length can be affected. Looking at the classification system When we look at the scheme we will notice that a fracture of the posterior malleolus in most cases is part of a Weber B or a Weber C fracture.
At the eight-week postoperative visit, you are asked to fill out a return to work form. Maisonneuve fracture Le Fort fracture of ankle Bosworth fracture. He subsequently undergoes surgical fixation, and a post-operative radiograph is shown in Figure A. About Blog Go ad-free. The CT-images show a epiphysiolysis fracture Salter Harris type 3.
We will first give a short overview of these fractures and then discuss them in more detail. Now we start looking for stage 3, which is a tertius fracture.
Any medial painful swelling or hematoma Normal radiographs do not rule out a Weber C fracture. A subtle high fibula fracture is seen arrow. The diagnosis as well as the treatment is usually no problem. Pronation Exorotation maisnneuve stage 4.
This is a transsyndesmotic fracture with usually partial – and less commonly, total – rupture of the syndesmosis. Here we see the different stages in the axial plane. The soft tissue swelling on the medial side is probably a rupture of the medial collateral bandi.
Maisonneuve fracture – WikEM
Example 3 Basic interpretation Dislocated bimalleolar fracture. In that case we have the following combination: Scaphoid Rolando Bennett’s Boxer’s Busch’s. Stage 1 – Avulsion of the medial malleolus or – ligamentous rupture Stage 2 – Rupture of the anterior syndesmosis Stage 3 – Fibula fracture above the level of the syndesmosis this is the true Weber C fracture Stage 4 – Avulsion of the posterior malleolus or – rupture of the posterior syndesmosis Scroll through the images.
The malleolar fracture usually starts medially at the level of the talar dome, but can fracturra start a few centimeters above this level.
According to Lauge Hansen we are probably dealing with: Stage Stage 3 More posterior displacement of the lateral malleolus fragment by the talus results in tension on the posterior syndesmosis with rupture or avulsion of the se malleolus. References [ edit ] Wilson, F.
Most type I growth plate injuries are treated with a cast. Rupture of the medial collateral ligaments – seen as widening of the space between the medial maieonneuve and the talus medial clear space. There is a subtle widening of the lateral part of the growth plate of the right ankle. Especially the medial swelling should make you consider a pronation exorotation injury Weber C.
Ankle Fractures – Trauma – Orthobullets
Loading Stack – 0 images remaining. It occurs before the distal tibial epiphysis has completely fused. Is this a case of a simple lateral malleolus maisonnueve This human musculoskeletal system article is a stub. We can not cathegorize this in the Weber classification, since there is no fibular fracture.
Normally you probably would not have noticed these. Likewise in some cases malalignment can result in a linear density. It will lead to rupture of the medial collateral ligament or avulsion of the medial malleolus.
Notice that on the radiograph of the ankle no fracture is seen. The fracture through the growth plate is usually obscure and difficult to differentiate from frxctura variations of the growth plate.
Which radiograph Figures A-E would best correlate with this finding?