{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:05:00Z","timestamp":1790949900493,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T00:00:00Z","timestamp":1599436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Maisonneuve fracture is a special type of injury which are rare in clinic. The manifestation of such fractures is variable. The aim of this study is to describe the pathoanatomical features of typical Maisonneuve fracture on the basis of radiographs, computed tomography (CT) scans, magnetic resonance imaging (MRI), and intraoperative exploration findings, and to investigate the injury mechanism of this variety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The data of 41 patients with Maisonneuve fracture from April 2014 to September 2019 were retrospectively analyzed. There were 32 males and nine females, the average age was 37.9\u2009years (range, 18 to 61\u2009years), the fractures occurred on the left side in 20 patients and on the right side in 21 patients. The cause of injuries were traffic accident in five patients, sprain injury in 20 patients, and falling injury from height in 16 patients. All patients underwent posteroanterior and lateral X\u2010ray examinations of the ankle and calf. CT scan of the ankle was performed in 38 patients, including three\u2010dimensional reconstruction in 33 patients. MRI examination of the ankle and calf was performed in 28 and five patients, respectively. Forty patients were treated with open reduction and internal fixation. The features of proximal fibular fracture, injuries of\u2009the\u2009medial and posterior structures of the ankle, injuries of\u2009the anterior inferior tibiofibular ligament and the interosseous membrane were recorded and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010one patients had proximal one\u2010third fractures of the fibula including six patients with fracture involving the fibular neck, 30 with proximal one\u2010third fractures of the fibular shaft, and five with proximal\u2013medial one\u2010third junction fracture of the fibular shaft. Thirty\u2010five patients (35\/41, 85.37%) with injury of posterior structures, 34 patients had posterior malleolar fracture (34\/41, 82.93%), and one patient had posterior inferior tibiofibular ligament rupture (1\/41, 2.44%). There were 20 patients with type I fracture, four patients with type II fracture, and 10 patients with type III fracture according to the Haraguchi classification of posterior malleolus fracture. The fracture of the medial malleolus was in 30 patients (30\/41, 73.17%), rupture of the deltoid ligament was in 10 patients (10\/41, 24.39%), and medial structures intact were in one patient (1\/41, 2.44%). All 41 patients had injury of the anterior inferior tibiofibular ligament.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maisonneuve fracture is characterized by fractures of the proximal fibula and the complete rupture of the anterior inferior tibiofibular ligament. Pronation\u2013external rotation is the main injury mechanism. The manifestations of typical Maisonneuve fracture including that the fibular fracture located in proximal one\u2010third diaphysis and the fracture line was from anterosuperior to posteroinferior.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12733","type":"journal-article","created":{"date-parts":[[2020,9,11]],"date-time":"2020-09-11T07:52:52Z","timestamp":1599810772000},"page":"1644-1651","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Pathoanatomy and Injury Mechanism of Typical Maisonneuve Fracture"],"prefix":"10.1111","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6732-6561","authenticated-orcid":false,"given":"Jin\u2010quan","family":"He","sequence":"first","affiliation":[{"name":"The First Department of Foot and Ankle Surgery Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin\u2010long","family":"Ma","sequence":"additional","affiliation":[{"name":"The First Department of Foot and Ankle Surgery Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing\u2010yi","family":"Xin","sequence":"additional","affiliation":[{"name":"The First Department of Foot and Ankle Surgery Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong\u2010bin","family":"Cao","sequence":"additional","affiliation":[{"name":"The First Department of Foot and Ankle Surgery Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Li","sequence":"additional","affiliation":[{"name":"The First Department of Foot and Ankle Surgery Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen\u2010hui","family":"Sun","sequence":"additional","affiliation":[{"name":"The First Department of Foot and Ankle Surgery Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gui\u2010xin","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Department of Foot and Ankle Surgery Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Fu","sequence":"additional","affiliation":[{"name":"The First Department of Foot and Ankle Surgery Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhao","sequence":"additional","affiliation":[{"name":"The First Department of Foot and Ankle Surgery Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang\u2010ke","family":"Hu","sequence":"additional","affiliation":[{"name":"The First Department of Foot and Ankle Surgery Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,7]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"165","article-title":"Recherches sur la fracture du perone","volume":"7","author":"Maisonneuve JG","year":"1840","journal-title":"Arch Gen Med"},{"key":"e_1_2_5_3_1","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1053\/j.jfas.2010.08.017","article-title":"Evidence\u2010based treatment of maisonneuve fractures","volume":"50","author":"Stufkens SA","year":"2011","journal-title":"J Foot Ankle Surg"},{"key":"e_1_2_5_4_1","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1053\/j.jfas.2016.10.003","article-title":"Maisonneuve equivalent injury with proximal tibiofibular joint dislocation: case report and literature review","volume":"56","author":"Bissuel T","year":"2017","journal-title":"J Foot Ankle Surg"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/OAJSM.S41564"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1950.01250010980011"},{"key":"e_1_2_5_7_1","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1097\/00003086-199302000-00034","article-title":"The Maisonneuve fracture of the fibula","volume":"287","author":"Merrill KD","year":"1993","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_5_8_1","doi-asserted-by":"crossref","first-page":"687","DOI":"10.3928\/0147-7447-20000701-15","article-title":"Operative treatment for Maisonneuve fracture of the proximal fibula","volume":"23","author":"Babis GC","year":"2000","journal-title":"Orthopedics"},{"key":"e_1_2_5_9_1","doi-asserted-by":"crossref","first-page":"C107","DOI":"10.1016\/S0020-1383(00)80038-8","article-title":"A sample of Chinese literature MRI 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