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Fibular Fracture

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Other Names

  • Isolated fibula fracture
  • Fibula Fracture
  • Mid Shaft Fibular Fracture
  • Proximal Fibular Fracture
  • Maisonneuve fracture
  • Dupuytren's Fracture
  • Frenchman's Fibular Fracture

Background

History

  • Maisonneuve fractures are named after French surgeon Jules Germain Francois Maisonneuve[1]

Epidemiology

  • Very little literature on the epidemiology of isolated fibular fractures[2]

Pathophysiology

  • General
    • Isolated fibula fractures are rare
  • Etiology
    • Fall
    • Direct blow or blunt trauma (sports, MVC)
    • Penetrating trauma (gunshot wounds)

Maisonneuve Fracture

Associated Injuries

Pathoanatomy


Risk Factors


Differential Diagnosis


Clinical Features

  • History
    • Some type of trauma to the leg should be obvious in the history
    • The patient will be tender over the fracture area
  • Physical Exam: Physical Exam Leg
  • Special Tests

Evaluation

Radiograph of right tibia fibula consistent with Maisonneuve fracture

Radiographs

  • Standard Radiographs Tibia Fibula
    • Sufficient to make diagnosis
    • Generally should image the knee and ankle as well
  • Shaft Fracture Findings
    • Disruption of osseous cortex
  • Proximal fractures/ Maisonneuve
    • May show a fracture of the medial malleolus, widening of the medial ankle joint

Classification

  • There is currently no classification for mid-shaft or proximal fibula fractures

Management

Prognosis

Nonoperative

  • Indications - Shaft fractures
    • Majority of cases
    • Absence of complications or co-injuries
  • Indications - Proximal fractures/ Maisonneuve
    • Stable syndesmosis, ankle joint under stress radiographs

Operative

  • Indications
    • Most Maissoneuve fractures
  • Technique
    • Most fibular fractures do not require fixation
    • Repair any ankle injuries, syndesmotic injuries

Rehab and Return to Play

Rehabilitation

  • Needs to be updated

Return to Play

  • Needs to be updated

Complications


See Also


References

  1. Maisonneuve, J. G. (1840). Recherches sur la fracture du péroné. Paris. France: Loquin & Cie.
  2. Pankovich AM. Fractures of the fibula proximal to the distal tibiofibular syndesmosis. J Bone Joint Surg Am. 1978 Mar;60(2):221-9. PMID: 417086.
  3. Kelsey JL, Keegan TH, Prill MM, Quesenberry CP Jr, Sidney S. Risk factors for fracture of the shafts of the tibia and fibula in older individuals. Osteoporos Int. 2006 Jan;17(1):143-9. doi: 10.1007/s00198-005-1947-8. Epub 2005 Aug 9. PMID: 16088362.
Created by:
John Kiel on 7 July 2019 07:18:02
Authors:
Last edited:
30 May 2021 01:01:12
Categories:
Lower Extremity | Trauma | Leg | Fractures | Acute