Objective To analyze the causes of misdiagnosis and preventive measures of Maisonneuve fracture of the fibula(MFF)in clinical practice.Methods The clinical data of 18 patients with misdiagnosed MFF treated from November 2019 to December 2022 were retrospectively analyzed.Results All the 18 cases had acute closed injury caused by external unilateral rotation of the ankle joint.Five patients presented with ankle pain,swelling,ecchymosis,and limited movement,5 patients with tenderness,swelling,and ecchymosis in the deltoid ligament area,and 8 patients with obvious pain in the peri-ankle area.After physical examination and anterior-lateral X-ray examination and/or MRI examination of the ankle,the initial diagnosis was medial malleolus fracture in 5 cases,deltoid ligament fracture in 5 cases,and soft tissue injury of the ankle in 8 cases.MFF was confirmed by full-length anterolateral X-ray or ankle acupoint X-ray at self-weight stress position of the ankle,ankle MRI examination.The duration of misdiagnosis was 2-13 d.After diagnosis,18 cases underwent surgical treatment.The patients had primary healing,fibula length recovered,and ankle joint function basically returned to normal.Conclusion MFF is relatively rare in clinical practice,with atypical early symptoms and mild pain at the proximal end of the fibula.It is difficult to detect evidence of proximal fibular injury or fracture,which can easily lead to early misdiagnosis.In order to avoid early misdiagnosis of MFF,full length X-ray examination of tibia and fibula or ankle acupoint X-ray examination at self-weight stress position of the ankle should be performed for patients with ankle injury symptoms.
关键词
Maisonneuve骨折/误诊/内踝骨折/后踝骨折/三角韧带断裂/软组织损伤/磁共振成像/诊断
Key words
Maisonneuve fracture of the fibula/Misdiagnosis/Internal ankle fracture/Posterior ankle fracture/Tri-angular ligament rupture/Soft tissue injury/Magnetic resonance imaging/Diagnosis
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万方数据