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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So at second look you notice a subtle widening of the lateral clear space on the original films, which could indicate but is definitely no proof of a syndesmotic rupture.
Fractura de peroné
It is a high Weber C fracture. Loading Stack – 0 images remaining. Re-examination No maisonneyve of an oblique fracture of the lateral malleolus, so we can exclude a Weber B fracture. CT scans note anteromedial marginal impaction. Fractures of the ankle: Fractra also that the medial epiphysis is already closed, while the lateral portion is still open blue arrows. His immediate post-operative AP radiograph is seen in Figure A.
Final report Weber C fracture stage 4.
Wheeless’ Textbook of Orthopaedics
Final report Weber B fracture. The fracture occurs when the medial epiphysis has fused and the lateral part becomes avulsed at the attachment of the anterior tibiofibular ligament or syndesmosis.
Duverney fracture Pipkin fracture. Notice that on the radiograph of the ankle no fracture is maisonneuvd. The Physician and Sportsmedicine. L8 – 10 years in practice.
Normally you probably would not have noticed these.
As a result more rotation of the talus will fracture the fibula in an oblique or spiral fashion because the lateral malleolus is pushed off from anteromedially to posterolaterally. In fact this is an unstable ankle fracture, since there also must be a rupture of the medial collateral ligament stage 1so the ring is broken in two places leading to instability.
Stage 1 The first injury will occur on the medial maisonnfuve, which is under maximum tension due to the pronation.
The radiographs shows maisonnneuve Weber C fracture. In such a case, you have to rule out a Maisonneuve fracture, which is a fracturx Weber C fracture. The sequences in a Weber B fracture or Lauge-Hansen supination exorotation injury take place in a clockwise manner: This case demonstrates that there can be an unstable ankle injury that needs surgery even when the radiographs of the ankle do not show a fracture.
In other projects Wikimedia Commons. Widening of the tibia-fibular clear space with external rotation stress would be a result of injury of which structure? The images show the usual Weber type A fractures. Final report Weber C stage 4, i. The injury results in: Type IV Type IV is a fracture through all three elements of the bone, the growth plate, metaphysis and epiphysis.
Final diagnosis is a Weber C fracture or according to Lauge Hansen: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Finally the posterior syndesmotic ligament ruptures, or vractura is an avulsion of the posterior malleolus, also known as posterior malleolus fracture red arrow.
Especially the medial swelling should make you consider a maisoneuve exorotation injury Weber C.
Maisonneuve fracture – WikEM
Example 3 In this case no fracture is seen, but only soft tissue swelling on the medial side. This was thought to be an avulsion of the posterior malleolus. Rractura of the following is most appropriate step based on Figures A and B? When we study the radiographs of a patient with an ankle injury, we have to study the region of the posterior malleolus very carefully.
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 maisonneuce a Weber C fracture. Weber A fractures are usually not a problem. The injury can continue to the following: Medial soft tissue swelling and a tertius fracture are both indications of a Weber C or Pronation Exorotation injury. Medial malleolus Anterior syndesmosis Fibula Posterior syndesmosis.
It is amazing, that such a large tertius fragment is so difficult to see on the radiographs. Radiographics full text – Pubmed citation.
The Frenchman’s fibular fracture (Maisonneuve fracture).
Epiphyseal fracture in the sagittal plane Injury to the growth plate in the axial plane Metaphyseal fracture in the coronal plane. HPI – While walking the patient twists her ankle and had a bimaleolar ankle fracture 6 months ago. Edit article Share article View revision history.
Enormous forces must have pushed off the medial frractura. So even in a Weber C stage 4 sometimes only a fracture of the medial malleolus will be visible.
Weber B This is a transsyndesmotic fracture with maiosnneuve partial – and less commonly, total – rupture of the syndesmosis. Weber C stage 3 also known as a Maisonneuve fracture. This case illustrates the importance of medial soft tissue swelling aswell as the finding of a tertius fracture.