Proximal Fibular Fracture
What is it? A fracture of the proximal portion of the fibula.
How does it present? A fracture of the proximal fibula that occurs from transmitted forces from an ankle eversion injury is called a Maisonneuve fracture. Other fractures of the proximal fibula may occur from direct trauma to that area. The common peroneal nerve crosses the neck of the fibula and can be injured in a fracture of this area. The nerve then splits at the level of the proximal fibula to the superficial branch which innervates ankle plantar flexion and eversion and the deep branch which innervates ankle and toe dorsiflexion. Any evidence of nerve injury should prompt immediate orthopedic evaluation.
Common exam findings: Pain and swelling over the fracture site. Crepitus may also be appreciated. A thorough exam should evaluated for any vascular or neurologic compromise.
Tests and Treatment: Most fractures are well visualized anteroposterior (AP) and lateral x-rays of the fibula. Treatment may be either conservative immobilization or surgical intervention.