Management of an Individual With a Maisonneuve Fracture: A Case Report With 3-Year Follow-up

BACKGROUND: Maisonneuve fractures (MFs) are caused by a traumatic ankle injury causing medial ligament rupture or medial malleolar fracture, distal tibia/fibula joint disruption, and proximal fibula fracture resulting in ankle instability which can lead to post-traumatic ankle arthritis. CASE PRESENTATION: A 58-year-old female fell snow skiing and was diagnosed with a right proximal fibula fracture in the emergency department. Due to concern of an MF, her physical therapist (PT) referred the patient to a board-certified, fellowship-trained foot and ankle surgeon who confirmed the diagnosis of MF. The patient underwent TightRope TM fixation with management by a PT for 4 months following surgery. OUTCOME AND FOLLOW-UP: Postsurgery Lower Extremity Functional Scale (LEFS) scores were 79/80 at 60 weeks. At 2 and 3 years following surgery Y-balance scores showed no significant differences between affected and unaffected limbs. After 3 years, gait speed and step length were within normal limits with no deficits noted in limb comparison. DISCUSSION: An accurate diagnosis for individuals sustaining a MF is important to optimize long-term outcomes. PTs can play a key role in the accurate and timely diagnosis of MF and their patients’ subsequent management to optimize recovery. JOSPT Cases 2025;5(1):66-70. Epub 12 December 2024. doi:10.2519/josptcases.2024.0016