不同类型Maisonneuve骨折的影像解剖学特征和损伤机制OACSTPCD

Objective To investigate the imaging anatomic features and injury mechanisms of different types of Maisonneuve fractures.Methods The clinical data of 37 patients with Maisonneuve fractures admitted to No.971 Hospital of PLA Navy from Janu-ary 2017 to January 2024 were retrospectively analyzed.All patients underwent anteroposterior and lateral X-ray examination of the full length of the ankle joint,tibia and fibula,36 patients underwent ankle CT scan and 26 patients underwent MRI of the ankle joint.The proximal fibula fractures,medial and posterior ankle structural injuries,anterior tibiofibular ligament and interosseous membrane inju-ries were recorded and analyzed.Results All the 37 patients suffered from proximal fibula fractures,including 5 cases(13.51%)of fibular neck fractures,29 cases(78.38%)of proximal fibula fractures,and 3 cases(8.11%)of fractures at the junction of the mid-dle and upper 1/3 of the fibula shaft.There were 32 patients(86.49%)with posterior ankle structural injuries,including 31 cases(83.78%)of posterior ankle fractures and 1 case(2.70%)with inferior posterior tibiofibular ligament fracture.All 37 patients had anterior tibiofibular ligament injuries,including 1 case of anterior tibiofibular ligament rupture and proximal fibula and posterior ankle fractures,but the medial ankle structure was intact.The injury mechanism of 36 cases was Lauge-Hanson classification of pronation-ex-ternal rotation,and 1 case was supination-external rotation.Conclusions Proximal fibula fracture and anterior inferior tibiofibular liga-ment ruptures are the basic features of Maisonneuve fractures,and pronation-external rotation is the main mechanism of injury.Preop-erative diagnosis should fully consider the limitations of X-ray examination,and patients should be carefully diagnosed with CT or MRI to avoid missed diagnosis.