Arthroscopic Findings in Maisonneuve Injuries
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Published:
Feb 14, 2022
Keywords:
Injury, fracture, Maisonneuve, ankle, arthroscopy, findings
Main Article Content
Abstract
Objective: The purpose of this study is to analyze arthroscopic findings in Maisonneuve lesions treated by arthroscopicallyassisted reduction and percutaneous fixation.
Materials and Methods: We evaluated the registry of patients operated on between May 2013-January 2019 with acute Maisonneuve lesions, treated by arthroscopically-assisted reduction and percutaneous fixation. We analyzed arthroscopic findings (chondral or osteochondral lesions, intra-articular loose fragments, injury of the distal tibiofibular joint with or without instability, and injury of the deltoid ligament with or without medial instability).
Results: 13 ankles in 13 patients were evaluated. 100% evidenced injury of the anterior distal tibiofibular ligament and instability of the distal tibiofibular joint. 92.30% had medial structure injuries, 76.9% with complete deltoid ligament injury with instability and 15.38% with medial malleolus fractures. In 1 patient (7.69%), no medial injury was evidenced. 84.61% of patients presented chondral or osteochondral lesions. 53.84% (7 patients) of cases had intra-articular loose fragments.
Conclusion: Maisonneuve lesions are a consequence of high-energy trauma and present with a high incidence of intra-articular structure injuries (ligaments and articular surface). Arthroscopy is a very useful tool to identify and treat intra-articular injuries, which would otherwise not be recognized.
Materials and Methods: We evaluated the registry of patients operated on between May 2013-January 2019 with acute Maisonneuve lesions, treated by arthroscopically-assisted reduction and percutaneous fixation. We analyzed arthroscopic findings (chondral or osteochondral lesions, intra-articular loose fragments, injury of the distal tibiofibular joint with or without instability, and injury of the deltoid ligament with or without medial instability).
Results: 13 ankles in 13 patients were evaluated. 100% evidenced injury of the anterior distal tibiofibular ligament and instability of the distal tibiofibular joint. 92.30% had medial structure injuries, 76.9% with complete deltoid ligament injury with instability and 15.38% with medial malleolus fractures. In 1 patient (7.69%), no medial injury was evidenced. 84.61% of patients presented chondral or osteochondral lesions. 53.84% (7 patients) of cases had intra-articular loose fragments.
Conclusion: Maisonneuve lesions are a consequence of high-energy trauma and present with a high incidence of intra-articular structure injuries (ligaments and articular surface). Arthroscopy is a very useful tool to identify and treat intra-articular injuries, which would otherwise not be recognized.
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How to Cite
Rofrano, M., & Herrera, H. (2022). Arthroscopic Findings in Maisonneuve Injuries. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(1), 5-14. https://doi.org/10.15417/issn.1852-7434.2022.87.1.1350
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Clinical Research
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References
1. Maisonneuve JG. Recherches sur la fracture du péroné. Arch Gen Med 1840;7:165-87, 433-73.
2. Bauer M, Jonsson K, Nilsson B. Thirty-year follow-up of ankle fractures. Acta Orthop Scand 1985;56(2):103-6.
https://doi.org/10.3109/17453678508994329
3. van Dijk CN, Verhagen RAW, Tol JL. Arthroscopy for problems after ankle fracture. J Bone Joint Surg Br
1997;79(2):280-4. https://doi.org/10.1302/0301-620x.79b2.7153
4. Loren GJ, Ferkel RD. Arthroscopic assessment of occult intra-articular injury in acute ankle fractures. Arthroscopy 2002;18(4):412-21. https://doi.org/10.1053/jars.2002.32317
5. Hintermann B, Regazzoni P, Lampert C, Stutz G, Gächter A. Arthroscopic findings in acute fractures of the ankle. J Bone Joint Surg Br 2000;82(3):345-51. https://doi.org/10.1302/0301-620x.82b3.10064
6. Stufkens SA, Knupp M, Horisberger M, Lampert C, Hintermann B. Cartilage lesions and the development of
osteoarthritis after internal fixation of ankle fractures: a prospective study. J Bone Joint Surg Am 2010;92(2):279-86. https://doi.org/10.2106/JBJS.H.01635
7. Sherman TI, Casscells N, Rabe J, McGuigan FX. Ankle arthroscopy for ankle fractures. Arthrosc Tech
2015;4(1):e75-e79. https://doi.org/10.1016/j.eats.2014.11.004
8. Ferkel RD, Orwin JF. Arthroscopic treatment of acute ankle fractures and postfracture defects. En: Ferkel RD (ed). Arthroscopic surgery: The foot and ankle. Philadelphia: Lippincott-Raven; 1996:185-200.
9. Cheng YM, Huang PJ, Hong SH. Low tibial osteotomy for moderate ankle arthritis. Arch Orthop Trauma Surg
2001;121(6):355-8. https://doi.org/10.1007/s004020000243
10. Ferkel RD. Diagnostic arthroscopic examination. En: Ferkel RD (ed). Arthroscopic surgery: The foot and ankle.
Philadelphia: Lippincott-Raven; 1996;103-18.
11. Ogilvie-Harris DJ, Reed SC. Disruption of the ankle syndesmosis: diagnosis and treatment by arthroscopic surgery. Arthroscopy 1994;10(5):561-8. https://doi.org/10.1016/s0749-8063(05)80015-5
12. Takao M, Ochi M, Oae K, Naito K, Uchio Y. Diagnosis of a tear of the tibiofibular syndesmosis. The role of
arthroscopy of the ankle. J Bone Joint Surg Br 2003;85(3):324-9. https://doi.org/10.1302/0301-620x.85b3.13174
13. Van den Bekerom MP, Mutsaerts EL, van Dijk CN. Evaluation of the integrity of the deltoid ligament in supination external rotation ankle fractures: a systematic review of the literature. Arch Orthop Trauma Surg 2009;129(2):227-35. https://doi.org/10.1007/s00402-008-0768-6
14. Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair. J Bone Joint Surg Am 2003;85(Suppl 2):58-69. https://doi.org/10.2106/00004623-200300002-00008
15. Elias I, Zoga AC, Morrison WB, Besser MP, Schweitzer ME, Raikin SM. Osteochondral lesions of the talus:
localization and morphologic data from 424 patients using a novel anatomical grid scheme. Foot Ankle Int
2007;28(2):154-61. https://doi.org/10.3113/FAI.2007.0154
16. Bartonicek J, Rammelt S, Kassper S, Malík J, Tucek M. Pathoanatomy of Maisonneuve fracture based on radiologic and CT examination. Arch Orthop Trauma Surg 2019;139(4):497-506. https://doi.org/10.1007/s00402-018-3099-2
17. Yoshimura I, Naito M, Kanazawa K, Takeyama A, Ida T. Arthroscopic findings in Maisonneuve fractures. J Orthop Sci 2008;13(1):3‐6. https://doi.org/10.1007/s00776-007-1192-4
18. Lauge-Hansen N. Fractures of the ankle II. Combined experimental-surgical and experimental-roentgenologic investigations. Arch Surg 1950;60(5):957-85. PMID: 15411319
19. Nielson JH, Sallis JG, Potter HG, Helfet DL, Lorich DG. Correlation of interosseous membrane tears to the level of the fibular fracture. J Orthop Trauma 2004;18(2):68-74. https://doi.org/10.1097/00005131-200402000-00002
20. Manyi W, Guowei R, Shengsong Y, Chunyan J. A sample of Chinese literature MRI diagnosis of interosseous
membrane injury in Maisonneuve fractures of the fibula. Injury 2000;31(Suppl3):C107-10. https://doi.org/10.1016/s0020-1383(00)80038-8
21. Pankovich AM. Maisonneuve fracture of the fibula. J Bone Joint Surg Am 1976;58(3):337-42. PMID: 816799
22. Chen XZ, Chen Y, Liu CG, Yang H, Xu XD, Lin P. Arthroscopy-assisted surgery for acute ankle fractures: A
systematic review. Arthroscopy 2015;31(11):2224-31. https://doi.org/10.1016/j.arthro.2015.03.043
23. Berndt AL, Harty M. Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg Am
1959;41:988-1020. PMID: 13849029
2. Bauer M, Jonsson K, Nilsson B. Thirty-year follow-up of ankle fractures. Acta Orthop Scand 1985;56(2):103-6.
https://doi.org/10.3109/17453678508994329
3. van Dijk CN, Verhagen RAW, Tol JL. Arthroscopy for problems after ankle fracture. J Bone Joint Surg Br
1997;79(2):280-4. https://doi.org/10.1302/0301-620x.79b2.7153
4. Loren GJ, Ferkel RD. Arthroscopic assessment of occult intra-articular injury in acute ankle fractures. Arthroscopy 2002;18(4):412-21. https://doi.org/10.1053/jars.2002.32317
5. Hintermann B, Regazzoni P, Lampert C, Stutz G, Gächter A. Arthroscopic findings in acute fractures of the ankle. J Bone Joint Surg Br 2000;82(3):345-51. https://doi.org/10.1302/0301-620x.82b3.10064
6. Stufkens SA, Knupp M, Horisberger M, Lampert C, Hintermann B. Cartilage lesions and the development of
osteoarthritis after internal fixation of ankle fractures: a prospective study. J Bone Joint Surg Am 2010;92(2):279-86. https://doi.org/10.2106/JBJS.H.01635
7. Sherman TI, Casscells N, Rabe J, McGuigan FX. Ankle arthroscopy for ankle fractures. Arthrosc Tech
2015;4(1):e75-e79. https://doi.org/10.1016/j.eats.2014.11.004
8. Ferkel RD, Orwin JF. Arthroscopic treatment of acute ankle fractures and postfracture defects. En: Ferkel RD (ed). Arthroscopic surgery: The foot and ankle. Philadelphia: Lippincott-Raven; 1996:185-200.
9. Cheng YM, Huang PJ, Hong SH. Low tibial osteotomy for moderate ankle arthritis. Arch Orthop Trauma Surg
2001;121(6):355-8. https://doi.org/10.1007/s004020000243
10. Ferkel RD. Diagnostic arthroscopic examination. En: Ferkel RD (ed). Arthroscopic surgery: The foot and ankle.
Philadelphia: Lippincott-Raven; 1996;103-18.
11. Ogilvie-Harris DJ, Reed SC. Disruption of the ankle syndesmosis: diagnosis and treatment by arthroscopic surgery. Arthroscopy 1994;10(5):561-8. https://doi.org/10.1016/s0749-8063(05)80015-5
12. Takao M, Ochi M, Oae K, Naito K, Uchio Y. Diagnosis of a tear of the tibiofibular syndesmosis. The role of
arthroscopy of the ankle. J Bone Joint Surg Br 2003;85(3):324-9. https://doi.org/10.1302/0301-620x.85b3.13174
13. Van den Bekerom MP, Mutsaerts EL, van Dijk CN. Evaluation of the integrity of the deltoid ligament in supination external rotation ankle fractures: a systematic review of the literature. Arch Orthop Trauma Surg 2009;129(2):227-35. https://doi.org/10.1007/s00402-008-0768-6
14. Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair. J Bone Joint Surg Am 2003;85(Suppl 2):58-69. https://doi.org/10.2106/00004623-200300002-00008
15. Elias I, Zoga AC, Morrison WB, Besser MP, Schweitzer ME, Raikin SM. Osteochondral lesions of the talus:
localization and morphologic data from 424 patients using a novel anatomical grid scheme. Foot Ankle Int
2007;28(2):154-61. https://doi.org/10.3113/FAI.2007.0154
16. Bartonicek J, Rammelt S, Kassper S, Malík J, Tucek M. Pathoanatomy of Maisonneuve fracture based on radiologic and CT examination. Arch Orthop Trauma Surg 2019;139(4):497-506. https://doi.org/10.1007/s00402-018-3099-2
17. Yoshimura I, Naito M, Kanazawa K, Takeyama A, Ida T. Arthroscopic findings in Maisonneuve fractures. J Orthop Sci 2008;13(1):3‐6. https://doi.org/10.1007/s00776-007-1192-4
18. Lauge-Hansen N. Fractures of the ankle II. Combined experimental-surgical and experimental-roentgenologic investigations. Arch Surg 1950;60(5):957-85. PMID: 15411319
19. Nielson JH, Sallis JG, Potter HG, Helfet DL, Lorich DG. Correlation of interosseous membrane tears to the level of the fibular fracture. J Orthop Trauma 2004;18(2):68-74. https://doi.org/10.1097/00005131-200402000-00002
20. Manyi W, Guowei R, Shengsong Y, Chunyan J. A sample of Chinese literature MRI diagnosis of interosseous
membrane injury in Maisonneuve fractures of the fibula. Injury 2000;31(Suppl3):C107-10. https://doi.org/10.1016/s0020-1383(00)80038-8
21. Pankovich AM. Maisonneuve fracture of the fibula. J Bone Joint Surg Am 1976;58(3):337-42. PMID: 816799
22. Chen XZ, Chen Y, Liu CG, Yang H, Xu XD, Lin P. Arthroscopy-assisted surgery for acute ankle fractures: A
systematic review. Arthroscopy 2015;31(11):2224-31. https://doi.org/10.1016/j.arthro.2015.03.043
23. Berndt AL, Harty M. Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg Am
1959;41:988-1020. PMID: 13849029