Yoshimura Ichiro, Naito Masatoshi, Kanazawa Kazuki, Takeyama Akinori, Ida Takahiro
Department of Orthopaedic Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
J Orthop Sci. 2008 Jan;13(1):3-6. doi: 10.1007/s00776-007-1192-4. Epub 2008 Feb 16.
A Maisonneuve fracture consists of a proximal fibular fracture with associated syndesmotic ligament disruption and injury to the medial ankle structures. The treatment outcome is good in most cases, although poor results have also been reported. The purpose of this study was to investigate intra-articular lesions in Maisonneuve fractures.
The subjects consisted of four patients (four ankle joints) who had suffered a Maisonneuve fracture and had undergone surgical treatment between June 2005 and November 2005. The mean age was 24. 2 years. At the time of surgery, we performed ankle arthroscopy and determined the presence of tibiofibular syndesmosis disruption, cartilaginous damage, and ligament damage. Lesions of the articular cartilage were graded by depth as determined by inspection and probing.
All four of the cases had cartilaginous damage to the medial section of the talar dome. Lateral lesions were not observed. Chondral debris and hemarthrosis were noted in virtually all cases, and each ankle had a tear on the anterior inferior tibiofibular ligament and interosseous tibiofibular ligament. No patients had a tear of the posterior inferior tibiofibular ligament.
Arthroscopy was useful in identifying associated intra-articular lesions in Maisonneuve fractures.
Maisonneuve骨折包括腓骨近端骨折,伴有下胫腓联合韧带断裂及内踝结构损伤。多数情况下治疗效果良好,不过也有报道称效果不佳。本研究的目的是调查Maisonneuve骨折的关节内损伤情况。
研究对象为2005年6月至2005年11月间发生Maisonneuve骨折并接受手术治疗的4例患者(4个踝关节)。平均年龄为24.2岁。手术时,我们进行了踝关节镜检查,并确定下胫腓联合是否断裂、软骨是否损伤以及韧带是否损伤。通过检查和探查确定关节软骨损伤的深度并进行分级。
所有4例均有距骨穹窿内侧软骨损伤,未观察到外侧损伤。几乎所有病例均可见软骨碎片和关节积血,每个踝关节的下胫腓前韧带和胫腓骨间韧带均有撕裂。没有患者的下胫腓后韧带撕裂。
关节镜检查有助于识别Maisonneuve骨折相关的关节内损伤。