Reoperation of Maisonneuve fracture with quatricortical syndesmotic screw, zip tight and fibula elongation by autograph: a case report in covid-19 patient

INTRODUCTION: Maisonneuve fracture includes a pattern of injuries characterized by fibula proximal fracture and unstable syndesmosis, which is frequently misdiagnosed. We describes the surgical technique and rehabilitation program in a Maisonneuve case, characterized by the rupture of trans-syndesmotic screw, in a Covid- 19 positive patient. PRESENTATION OF CASES: We report a case of 49- year old patient with a Maisonneuve fracture. The first surgery has failed with three-cortical screw rupture. The second surgery was based on the implantation of quatricortical screw, zip tight and fibula elongation with autograph. The results were excellent despite the patient having contracted Covid-19 virus during rehabilitation. BACKGROUND AND AIM: Maisonneuve fracture is a misdiagnosed injury. RX or TC of lower limb may make the diagnosis. The literature describes different surgical tecnique to stabilized and reduced the ankle. We believe that the gold standard is the correct realignment of syndesmosis and a strong synthesis. CONCLUSION: The Maisonneuve fracture accounts for 7% of all ankle fractures but it is frequently misdiagnosed. There is no doubt that interposition of quarantine after surgery mean a delay of rehabilitation. Despite this, the clinical and radiological controls were optimal with a good functional recovery at 6(th) months after surgery. The patient was satisfied and he returned to his daily life and physical activity. (www.actabiomedica.it)