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“Floating Fibula” Secondary to Traumatic Dislocation of the Ankle Joint, Ankle Syndesmosis, and the Proximal Tibiofibular JointA Case Report
Hwee Weng Hey, MBBS, MRCS, MMed(Orth), MCI1; Bernard Puang Huh Lau, MB, BCh BAO, MRCS1; Joseph Thambiah, MBBS, MMed(Surg), FRCS, FAMS1; Kok Sun Khong, MBBS, FRCS, MMed(Surg)1; Diarmuid Paul Murphy, MB, BCh BAO, FRCSI, FRCS(Tr&Orth)1
1 Department of Orthopaedic Surgery, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore 119228. E-mail address for H.W.D. Hey: hwee_weng_hey@nuhs.edu.sg
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Investigation performed at the Department of Orthopaedic Surgery, National University Hospital, Singapore



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Oct 23;3(4):e107 1-5. doi: 10.2106/JBJS.CC.M.00028
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Extract

The Maisonneuve fracture, described by Dr. Jules Germain François Maisonneuve in 18401, is a fracture of the proximal part of the fibula that is associated with an injury to the ankle. This is also known as a pronation-external rotation injury to the ankle that disrupts the medial ankle structures initially and propagates along the syndesmotic ligaments and interosseous membrane and then exits, with a resultant fracture in the proximal part of the fibula2. Many authors have described variations of this injury3-5. Levy et al. described a single case report of a medial malleolar avulsion injury that did not have a proximal fibular fracture, but there was disruption of the ankle syndesmosis and proximal tibiofibular dislocation4.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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