Fractures: Maisonneuve fracture: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Fractures: Maisonneuve fracture

Sample item

A patient with a twisting injury has tenderness at the medial ankle and a proximal fibular fracture on knee films. Which injury should be suspected?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Maisonneuve fracture with syndesmosis and medial structure disruption

In a Maisonneuve fracture, an external rotation force is transmitted along the interosseous membrane, tearing the syndesmosis and deltoid ligament or fracturing the medial malleolus, and causing a proximal fibular fracture. Ankle radiographs may look normal, so the whole leg must be imaged.

Option by option

  • A. Isolated fibular head avulsion

    An isolated fibular head avulsion would not cause medial ankle pain.

  • B. Maisonneuve fracture with syndesmosis and medial structure disruption (correct)

    Correct. A proximal fibula fracture with medial ankle tenderness suggests Maisonneuve injury.

  • C. Pilon fracture

    A pilon fracture is a vertical compression fracture of the distal tibia.

  • D. Lisfranc fracture-dislocation

    Lisfranc injury involves the midfoot.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Maisonneuve fracture with syndesmosis and medial structure disruption. In a Maisonneuve fracture, an external rotation force is transmitted along the interosseous membrane, tearing the syndesmosis and deltoid ligament or fracturing the medial malleolus, and causing a proximal fibular fracture.

Why is "Isolated fibular head avulsion" not the answer?

An isolated fibular head avulsion would not cause medial ankle pain.

Why is "Pilon fracture" not the answer?

A pilon fracture is a vertical compression fracture of the distal tibia.

Why is "Lisfranc fracture-dislocation" not the answer?

Lisfranc injury involves the midfoot.

What concept does this question test?

It tests Fractures: Maisonneuve fracture in Orthopaedics. Ankle radiographs may look normal, so the whole leg must be imaged.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Fractures: Maisonneuve fracture?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.