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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Now the injury can stop and there will only be a rupture of the medial collateral ligaments or avulsion of the medial malleolus. Type V growth plate injuries occur with the growth plate is crushed.
An isolated tertius fracture on the ankle radiographs indicates the presence of an unstable ankle injury. Final report Weber C fracture stage 4. So if there is a tertiu sfracture and no sign of a Weber B fracture, then we have to start looking for a high Weber C fracture.
Maisonneuve fracture | Radiology Reference Article |
As in most ankle fractures the mechanism is external rotation. It results from subtle malalignment of the tractura fragment. Bumper fracture Segond fracture Gosselin fracture Maisnoneuve fracture Pilon fracture Plafond fracture Tillaux fracture. How important is this topic for board examinations? On the lateral view a small tertius fragment is seen indicating stage 3.
The fracture through the growth plate is usually obscure and difficult to differentiate from normal variations of the growth plate. Type IV is a fracture through all three elements of the bone, the growth plate, metaphysis and epiphysis.
Proper positioning is also essential with type IV growth plate fractures, and surgery may be needed to hold fractjra bone fragments in proper position. HPI – While walking the patient twists her ankle and had a bimaleolar ankle fracture 6 months ago.
The Frenchman’s fibular fracture (Maisonneuve fracture).
It is a high Weber C fracture. The maisknneuve occurs when the medial epiphysis has fused and the lateral part becomes avulsed at the attachment of the anterior tibiofibular ligament or syndesmosis. Notice that all 4 stages are visible: Re-examination No sign of an oblique fracture of the lateral malleolus, so we can exclude a Weber B fracture.
Check for errors and try again. Medial avulsion fracture or rupture of the collateral band Rupture of the anterior syndesmosis Suprasyndesmotic rupture of the fibula due to rotation Posterior malleolus fracture or rupture of the posterior syndesmosis Scroll through the images.
Maisonneuve fracture Le Fort fracture of ankle Bosworth fracture. Weber B and C are more difficult and it is essential to understand the sequence of events in these injuries, which are both exorotation injuries. Always look for higher stages of an exorotation injury. Continue with the CT.
Here we have images of an extremely difficult case. The Lauge-Hansen classification will give you the fracture mechanism and the preliminary stage of the ankle injury. These are pull off type fractures as ce result of avulsion. What is the most reliable method to evaluate the competence of the deltoid ligament?
This type of injury can be difficult to detect. Anterior tibiofibular ligament sprain Lateral short oblique fibula fracture anteroinferior to farctura Posterior tibiofibular ligament rupture or avulsion of posterior malleolus Medial malleolus transverse fracture or disruption of deltoid ligament.
Medial and Lateral Bimalleolar Fracture. Medial malleolus transverse fracture or disruption of deltoid ligament Anterior tibiofibular ligament sprain Transverse comminuted fracture of the fibula above the level of the syndesmosis. Often type II growth plate fractures must be repositioned under anesthesia, but healing is usually quick and complications are uncommon. Notice however that this fracture line stops at the level of the epiphyseal plate.
Wheeless’ Textbook of Orthopaedics
Maybe the fracture is seen on the AP-view as indicated by the red arrows, but this is questionable. This impression will direct you to both a Weber as well as a Lauge-Hansen classification. Type I Salter-Harris fractures tend to occur in younger children 5. Once you understand the trauma mechanism as described by Lauge-Hansen and the sequence of events that take place in stages, then you know where to look for fractures and ligamentous injuries.