A Maisonneuve fracture refers to a break or fracture in the fibula close to the knee, with a co-occurring sprain in the ankle. The impact of a sprained ankle may travel up the leg and cause the fibula to fracture.
This article explains a Maisonneuve fracture, the anatomy of the injury, its causes, diagnosis, and treatment. It also outlines the recovery process and outlook for people with this kind of fracture.
A Maisonneuve fracture refers to
Symptoms may include those of a fracture and a sprain.
Fracture symptoms include:
- swelling and tenderness at the site of injury
- bruising around the injury
- pain which can prevent movement of the fractured area
Symptoms of a sprained ankle include:
- weakness and pain around the ankle
- the inability to put weight on the affected ankle
- loss of range of motion
- swelling and bruising around the ankle
A Maisonneuve fracture
The fibula, which people also refer to as the calf bone, is one of two long bones of the lower leg, along with the tibia. The fibula forms the top of the ankle and reaches to the back of the knee.
Ligaments connect bones, especially in the joints, and are strong and rope-like. Ligaments stabilize joints and help ensure they do not twist and dislocate. The major ligament in the ankle is the deltoid ligament, which attaches to the ankle, foot, and leg bones.
The ankle joint comprises the fibula, the distal tibia, and the talus, a bone in the ankle joined to the tibia and fibula. The medial malleolus at the bottom of the tibia, the lateral malleolus of the fibula in the lower leg, and the surface of the talus form the surface of the ankle.
In a Maisonneuve fracture, the extreme force resulting from external rotation of the foot strains the bones and ligaments in the ankle. The talus externally rotates, causing stress to the ankle and resulting in a malleolus fracture or a rupture in the deltoid ligament.
In the external rotation, the talus also puts pressure on the lateral malleolus and causes strain to the ligaments between the tibia and fibula. The force from the pressure travels upward through the medial malleolus and the deltoid ligament and causes the fibula to fracture.
Most pronation injuries are sports-related, although a person can also sustain this type of injury in other ways, such as in a car accident or while slipping, falling from a height, running, or walking.
Someone who takes part in a sport or activity where the leg and foot may hit the ground awkwardly during rotation, such as gymnastics or skiing, may be at higher risk of sustaining a Maisonneuve fracture.
To diagnose a Maisonneuve fracture, a doctor will carefully examine the area to determine the extent of the injury. They will typically ask questions about how the person sustained the injury, any symptoms they are experiencing, and the person’s medical history.
Doctors usually use X-rays to diagnose a fracture so they can view a clear image of the bones. An X-ray can also show what type of fracture someone has sustained and which areas of the bones are fractured.
After the leg and ankle heal, usually about
Following the screw removal, a person may work with an occupational therapist or physiotherapist in rehabilitation to strengthen the ankle and leg.
Fractures typically take between weeks and months to heal. Recovery from a Maisonneuve fracture depends on the extent of the injury, how closely a person follows their surgeon’s instructions, rehabilitation, and other factors.
During recovery, the pain usually recedes before the fracture is ready to bear weight and a person can perform their regular daily activities.
Even after surgery and screw removal, people may need to limit their movement until their ankle and leg are stronger.
While a person’s leg and ankle are healing, they may lose muscle strength and some range of motion. Rehabilitation can help people strengthen their ankle and leg and regain movement and flexibility.
After surgery, the outlook for a person with a Maisonneuve fracture is usually excellent. In some cases, people may experience a reduced range of motion in the ankle, and some may experience mild and occasional discomfort.
A 2010 review notes that most people are pain-free and have the full range of motion within 6 months of the procedure.
A Maisonneuve fracture refers to two injuries that occur at the same time. A sprain in the ankle, which a person most often experiences as a result of external rotation and pronation, causes stress that travels up the leg and results in a fibula fracture.
The most common cause of the injury is sports-related pronation-external rotation, although people may also sustain the injury in other ways. A doctor may diagnose the injury with X-rays and will typically treat it through surgery.
Surgery for a Maisonneuve fracture involves inserting screws to hold the ankle in place while the ligaments heal. A surgeon later removes the screws. The outcome of surgery for a Maisonneuve fracture is usually excellent.