A Maisonneuve fracture is caused by pronation and external rotation. It can be difficult to find, even if we get fixated on the ankle.
The patient may present with a complaint of rolling their ankle and ankle pain. Be vigilant for this type of injury. It is made of two main components:
- A spiral fracture of the proximal fibula
- An unstable ankle injury
This would result in a widening of the ankle joint due to distal tibiofibular syndesmosis and/or deltoid ligament disruption, or fracture of the medial malleolus.  Surgical Treatment is needed.
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Case courtesy of Dr Roberto Schubert, Radiopaedia.org. From the case rID: 16795Â