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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Usually there is a total rupture of the syndesmosis with instability of fracturz ankle. Which of the following could have prevented this patient from developing persistent pain? Final report Trimalleolar fracture. The medial clear space is only slightly widened, but based on the stages of Lauge Hansen there must be a collateral band rupture. This is un unstable ankle injury that needs surgical repair.
It is a high Weber C fracture. It is the most difficult fracture to diagnose and the Lauge-Hansen system will help you to understand the fracture-mechanism, as this will be an enormous help.
Patient was not treated properly because she was in a remote area. This is stage 2 and we have to assume, that the anterior syndesmosis is ruptured.
Rupture of the anterior tibiofibular ligament Oblique fracture of the distal fibula Avulsion of the posterior malleolus or rupture of the posterior tibiofibular ligament Avulsion of the medial malleolus or rupture of the medial collateral ligament Immediately after the injury the injured parts may again align, which can make it difficult to detect the injuries. Stage 1 is rupture of the medial collateral ligaments and stage 3 is a fibula fracture above the level of the syndesmosis.
The images show an obvious Weber B fracture. Notice that there is also an avulsion at the tibial insertion of the anterior syndesmosis, i.
Is this a case of a simple lateral malleolus fracture? After this re-examination you can make a final report. Type Fracturra A type II growth plate fracture starts across the growth plate, but the fracture then continues up through the metaphysis. Stage-2 is extremely uncommon. So this injury is probably a pronation exorotation injury PER stage 1 or higher.
The Radiology Assistant : Ankle – Special fracture cases
Loading Stack – 0 images remaining. These are discussed in the next chapter. These types of fractures may permanently injure the growth plate, requiring later treatment to restore alignment of the limb. There is also amisonneuve very subtle fracture through the epiphysis.
Isolated fracture of the medial malleolus Isolated fracture of the posterior malleolus without a fracture on the lateral side Any painful swelling or hematoma on the medial side without a fracture on the radiographs. Fradtura is an unstable fracture with dislocation that needs surgical repair.
The diagnosis as well as the treatment fractur usually no problem. Classification The fracture starts at the level of the ankle joint and extends proximally, i. You can help Wikipedia by expanding it. In some cases a fracture of the posterior malleolus is barely or not visible on the radiographs and can only be seen on CT.
The lateral side is under extreme tension with stretch on the ligaments which results in an avulsion fracture. The fracture through the growth plate is only seen on CT. Stage 1 – Avulsion of the medial malleolus or – ligamentous rupture Stage 2 – Rupture of the anterior syndesmosis Stage 3 – Fibula fracture above the level of the syndesmosis this is the true Weber C fracture Stage 4 – Avulsion of the posterior malleolus or – rupture of the posterior syndesmosis Scroll through the images.
Classification according to Weber is not possible. These are pull off type fractures as a result of avulsion. The sequences in a Weber B fracture or Lauge-Hansen supination exorotation injury take place in a clockwise manner: On the AP-view the linear lucency is the clue to a tertius fracture red arrow. What we normally see is a stage 2 oblique fracture through the syndesmosis and we have to assume that there is also a rupture of the anterior tibiofibular ligament, which is stage 1.
Wheeless’ Textbook of Orthopaedics
Here we have images of an extremely difficult case. A radiograph of her ankle is shown in Figure A. It is caused by pronation external-rotation mechanism.
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 misonneuve to posterolaterally.
Ankle – Special fracture cases
In what direction is the fibula most unstable? The radiographs show a typical Weber B fracture.
Do you have an idea what kind of injury this is? Here more examples of the bright line that indicates a tertius fracture. On the lateral view the posterior cortex of the tibia is interrupted indicating a fracture blue arrow. So at second look you notice a subtle widening of the ds clear space on the original films, which could indicate but is definitely no proof of a syndesmotic rupture. There is still the possibility of a Weber C fracture stage 4, i.
Fractura de peroné – Wikipedia, la enciclopedia libre
Frctura such a case, you have to rule out a Maisonneuve fracture, which is a high Weber C fracture. Maisonneuve’s fracture Maisonneuve fractures. This is called a pull off type of fracture in contrast to a push off type, which is seen as an oblique or vertical fracture.
Most fractures of the posterior malleolus are part of a complex ankle injury, either Weber B or Weber C. Stage 1 The images show the usual Weber type A fractures. Her postoperative radiographs are shown in Figure A.
In some cases the tertius fractures are easily seen on the x-rays, but frequently they can be difficult to detect. Functional Bimalleolar Fracture deltoid ligament tear with fibular fracture.
His radiograph is shown in figure A. Do you see what stage this is?