A 35-year-old man sustains an ankle injury in a fall. Radiographs show a fracture of the medial malleolus with widening of the tibiofibular clear space, and he has point tenderness over the proximal fibula just below the knee. The most likely diagnosis is:

• A Maisonneuve fracture ✓
• B Dupuytren fracture-dislocation of the ankle
• C Tillaux fracture
• D Bosworth fracture-dislocation

Explanation

B Maisonneuve fracture is a pronation-external rotation injury in which the force travels up the interosseous membrane, disrupting the syndesmosis and producing a spiral fracture of the proximal third of the fibula. Any ankle injury with unexplained proximal fibular tenderness demands radiographs of the full leg. The Tillaux fracture is an adolescent distal tibial epiphyseal avulsion.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.