TY - JOUR
T1 - Evidence-based treatment of maisonneuve fractures
AU - Stufkens, Sjoerd A.
AU - van den Bekerom, Michel P.J.
AU - Doornberg, Job N.
AU - van Dijk, C. Niek
AU - Kloen, Peter
PY - 2011/1/1
Y1 - 2011/1/1
N2 - The objective of the current study was to review the published clinical evidence available for the treatment of Maisonneuve fractures. Medline via PubMed, Orthopaedic Trauma Association (OTA) annual meetings' abstracts archives Web site, Embase, the Cochrane Database of Systematic Reviews, and the Cochrane Clinical Trial register were searched for the period extending from January 1970 to May 2009 in order to identify studies relating to the treatment of Maisonneuve ankle fractures. Six level 4 (case series, N ≥ 5) studies, describing a total of 83 patients with a Maisonneuve fracture, were included in the review. Although the authors did not compare the different treatment strategies described in the reports, the overall outcomes were generally good, and included 74 (89%) patients in which the outcome was considered good or excellent, and 9 (11%) patients in which the outcome was considered fair or poor. Based on this review, some grade B and C recommendations for the treatment of Maisonneuve fractures were formulated, including: 1) the medial malleolus should be fixated, 2) the torn deltoid ligament need not be directly repaired, 3) syndesmotic instability can be treated with one or two 3- or 4-cortical screws and these can be placed percutaneously, and 4) the proximal fibular fracture does not require direct internal fixation. Recommendations for future research were also formulated and described in this report.
AB - The objective of the current study was to review the published clinical evidence available for the treatment of Maisonneuve fractures. Medline via PubMed, Orthopaedic Trauma Association (OTA) annual meetings' abstracts archives Web site, Embase, the Cochrane Database of Systematic Reviews, and the Cochrane Clinical Trial register were searched for the period extending from January 1970 to May 2009 in order to identify studies relating to the treatment of Maisonneuve ankle fractures. Six level 4 (case series, N ≥ 5) studies, describing a total of 83 patients with a Maisonneuve fracture, were included in the review. Although the authors did not compare the different treatment strategies described in the reports, the overall outcomes were generally good, and included 74 (89%) patients in which the outcome was considered good or excellent, and 9 (11%) patients in which the outcome was considered fair or poor. Based on this review, some grade B and C recommendations for the treatment of Maisonneuve fractures were formulated, including: 1) the medial malleolus should be fixated, 2) the torn deltoid ligament need not be directly repaired, 3) syndesmotic instability can be treated with one or two 3- or 4-cortical screws and these can be placed percutaneously, and 4) the proximal fibular fracture does not require direct internal fixation. Recommendations for future research were also formulated and described in this report.
KW - Ankle fracture
KW - Maisonneuve
KW - Osteosynthesis
KW - Proximal fibula
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=78650301483&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78650301483&partnerID=8YFLogxK
U2 - 10.1053/j.jfas.2010.08.017
DO - 10.1053/j.jfas.2010.08.017
M3 - Review article
C2 - 21172642
AN - SCOPUS:78650301483
SN - 1067-2516
VL - 50
SP - 62
EP - 67
JO - Journal of Foot and Ankle Surgery
JF - Journal of Foot and Ankle Surgery
IS - 1
ER -