Proximal tibiofibular dislocation: a case report and review of literature

JOURNAL TITLE: Strategies in Trauma and Limb Reconstruction

Author
1. T. Schepers
2. M. P. Somford
3. R. A. Nieuwe Weme
ISSN
1828-8936
DOI
10.1007/s11751-014-0209-8
Volume
9
Issue
3
Publishing Year
2014
Pages
5
Author Affiliations
    1. Department of Surgery, Isala klinieken, P.O. box 10400, 8000GK Zwolle, The Netherlands
    1. Department of Orthopaedic Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
    1. Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
  • Article keywords
    Dislocation, Fibula, Knee, Luxation, Tibia, Tibiofibular joint

    Abstract

    An isolated dislocation of the proximal tibiofibular joint is uncommon. The mechanism of this injury is usually sports related. We present a case where initial X-rays did not show the tibiofibular joint dislocation conclusively. It was diagnosed after comparative bilateral AP X-rays of the knees were obtained. A closed reduction was performed and followed by unrestricted mobilization after 1 week of rest. A review of the literature was conducted on PubMed MEDLINE. Thirty cases of isolated acute proximal tibiofibular joint dislocations were identified in a search from 1974. The most common direction of the dislocation was anterolateral, and common causes were sports injury or high velocity accident related. More than 75 % of the cases were successfully treated by closed reduction. Complaints, if any, at the last follow-up (averaging 10 months, range 0–108) were, in the worst cases, pain during sporting activities. We advise comparative knee X-rays if there is a presentation of lateral knee pain after injury and diagnosis is uncertain. Closed reduction is usually successful if a dislocation of the proximal tibiofibular joint is diagnosed. There is no standard for after-care, but early mobilization appears safe if there are no other knee injuries.

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