Outcome after surgery for Maisonneuve fracture of the fibula.

The aim of this study was to assess outcome in patients treated surgically for Maisonneuve fractures and to highlight factors associated with a suboptimal result. The authors present a review of 14 patients with Maisonneuve fractures. The mean age was 35.5 years. The most common injury mechanism was a twist incurred whilst participating in sport. The goal of treatment was the anatomic restoration of the ankle mortice with accurate renewal of fibular length. All patients had one or two suprasyndesmotic screws inserted percutaneously under fluoroscopic guidance. These were successfully removed under local anaesthesia in 13 cases (93%). Patients were reassessed clinically and evaluated both functionally and radiographically. Average follow-up was 25.3 months. Twelve patients (86%) had a satisfactory result. They returned to previous activity levels and had favourable Global Foot and Ankle (mean: 95.57) and Shoe Comfort (mean: 81.66) Raw Scores. Ankle range of motion and radiographs were normal. Two patients had an unsatisfactory result. Surgical intervention is recommended to maintain reduction of the fibula into the notch on the tibia, as shortening results in mandatory lateral talar displacement, predisposing to painful ankle arthrosis. The severity of the initial injury and co-morbid disease may adversely affect outcome.