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Imaging anatomic features and injury mechanism of Maisonneuve fractures with different clinical manifestations |
LI Xiaoliang, SUN Peifeng, LIU Hongguo, XIA Guofeng |
Department of Orthopedics, No. 971 Hospital of PLA Navy, Qingdao 266071, China |
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Abstract Objective To investigate the imaging anatomic features and injury mechanisms of different types of Maisonneuve fractures. Methods The clinical data of 37 patients with Maisonneuve fractures admitted to No. 971 Hospital of PLA Navy from January 2017 to January 2024 were retrospectively analyzed. All patients underwent anteroposterior and lateral X-ray examination of the full length of the ankle joint, tibia and fibula, 36 patients underwent ankle CT scan and 26 patients underwent MRI of the ankle joint. The proximal fibula fractures, medial and posterior ankle structural injuries, anterior tibiofibular ligament and interosseous membrane injuries were recorded and analyzed. Results All the 37 patients suffered from proximal fibula fractures, including 5 cases (13.51%) of fibular neck fractures, 29 cases (78.38%) of proximal fibula fractures, and 3 cases (8.11%) of fractures at the junction of the middle and upper 1/3 of the fibula shaft. There were 32 patients (86.49%) with posterior ankle structural injuries, including 31 cases (83.78%) of posterior ankle fractures and 1 case (2.70%) with inferior posterior tibiofibular ligament fracture. All 37 patients had anterior tibiofibular ligament injuries, including 1 case of anterior tibiofibular ligament rupture and proximal fibula and posterior ankle fractures, but the medial ankle structure was intact. The injury mechanism of 36 cases was Lauge-Hanson classification of pronation-external rotation, and 1 case was supination-external rotation. Conclusions Proximal fibula fracture and anterior inferior tibiofibular ligament ruptures are the basic features of Maisonneuve fractures, and pronation-external rotation is the main mechanism of injury. Preoperative diagnosis should fully consider the limitations of X-ray examination, and patients should be carefully diagnosed with CT or MRI to avoid missed diagnosis.
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Received: 08 August 2024
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[1] |
He J, Ma X, Hu Y, et al. Investigation of the characteristics and mechanism of interosseous membrane injuries in typical maisonneuve fracture[J].Orthop Surg, 2023,15(3):777-784.
|
[2] |
黎路根,胡争波. Maisonneuve骨折的诊疗研究进展[J]. 中华骨与关节外科杂志, 2020, 13(8):694-700.
|
[3] |
凡 军,沙 勇,纪亲龙,等. Maisonneuve骨折误诊原因分析[J]. 临床误诊误治, 2023, 36(10):10-13.
|
[4] |
Fraissler L, Mattiassich G, Brunnader L, et al. Arthroscopic findings and treatment of maisonneuve fracture complex[J]. BMC Musculoskelet Disord, 2021,22(1):821.
|
[5] |
李浩林,张俊忠. Maisonneuve骨折30例误漏诊分析[J]. 临床误诊误治, 2023, 36(1):14-18.
|
[6] |
Inokuchi R, Jujo Y, Iwashita K, et al. Maisonneuve fracture: a type of ankle fracture[J].BMJ Case Rep, 2019, 12(11):e231961.
|
[7] |
Pelton K, Thordarson D B, Barnwell J. Open versus closed treatment of the fibula in Maissoneuve injuries[J].Foot Ankle Int, 2010, 31(7):604-608.
|
[8] |
马 岗, 姜 宏, 张志刚, 等. Maisonneuve骨折的临床诊治特点及15例手术疗效分析[J]. 中国骨伤, 2020, 33(7):667-671.
|
[9] |
Bartonícek J, Rammelt S, Kasper S, et al. Pathoanatomy of Maisonneuve fracture based on radiologic and CT examination[J].Arch Orthop Trauma Surg, 2019, 139(4):497-506.
|
[10] |
尹 博, 周君琳, 刘 洋, 等. 一种特殊类型的Maisonneuve损伤的诊断和治疗[J]. 中华创伤骨科杂志, 2021, 23(2):162-166.
|
[11] |
Dietrich G, Prod’homme M, Müller J, et al. Conservative management of a specific subtype of Maisonneuve fractures: a report of two cases[J].AME Case Rep, 2022, 6:17.
|
[12] |
Alencar Neto J B, Cavalcante M L C, Pinto Neto L H, et al. Maisonneuve variant lesion with proximal tibiofibular dislocation [J].Rev Bras Ortop (Sao Paulo), 2019, 54(3):339-342.
|
[13] |
Liu G P, Li J G, Gong X, et al. Maisonneuve injury with no fibula fracture: a case report[J]. World J Clin Cases, 2021, 9(15):3733-3740.
|
[14] |
He J Q, Ma X L, Xin J Y, et al. Pathoanatomy and injury mechanism of typical maisonneuve fracture[J].Orthop Surg, 2020, 12(6):1644-1651.
|
[15] |
Cao M M, Zhang Y W, Hu S Y, et al. A systematic review of ankle fracture-dislocations: recent update and future prospects[J].Front Surg, 2022, 9: 965814.
|
[16] |
Charopoulos I, Kokoroghiannis C, Karagiannis S, et al. Maisonneuve fracture without deltoid ligament disruption: a rare pattern of injury[J].J Foot Ankle Surg, 2010, 49(1):86.e11-86.
|
[17] |
Wang M Y, Rong G W, Yand S S, et al. A sample of Chinese literature MRI diagnosis of interosseous membrane injury in Maisonneuve fractures of the fibula[J].Injury, 2000, 31(Suppl 3): C107-C110.
|
[18] |
李建鹏, 尹梦帆, 高 翔. 可吸收与金属螺钉固定Maisonneuve骨折比较[J]. 中国矫形外科杂志, 2024, 32(8):679-684.
|
[1] |
. [J]. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(10): 908-911. |
|
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