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VOLUME 9 , ISSUE 3 ( November, 2014 ) > List of Articles

CASE REPORT

Proximal tibiofibular dislocation: a case report and review of literature

R. A. Nieuwe Weme, M. P. Somford, T. Schepers

Keywords : Dislocation, Fibula, Knee, Luxation, Tibia, Tibiofibular joint

Citation Information : Weme RA, Somford MP, Schepers T. Proximal tibiofibular dislocation: a case report and review of literature. 2014; 9 (3):185-189.

DOI: 10.1007/s11751-014-0209-8

License: CC BY-NC-SA 4.0

Published Online: 30-11-2014

Copyright Statement:  Copyright © 2014; The Author(s).


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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  1. Ogden JA (1974) The anatomy and function of the proximal tibiofibular joint. Clin Orthop Relat Res (101):186-191
  2. Nelaton A (1874) Eléments de pathologie chirurgicale, 2nd edn. Librairie Germer Ballière, Paris, p 282
  3. Ahmad R, Case R (2008) Dislocation of the fibular head in an unusual sports injury: a case report. J Med Case Rep 2:158. doi:10.1186/1752-1947-2-158
  4. Sekiya JK, Kuhn JE (2003) Instability of the proximal tibiofibular joint. J Am Acad Orthop Surg 11:120-128
  5. Ogden JA (1974) Subluxation and dislocation of the proximal tibiofibular joint. J Bone Joint Surg Am 56(1):145-154
  6. Keogh P, Masterson E, Murphy B et al (1993) The role of radiography and computed tomography in the diagnosis of acute dislocation of the proximal tibiofibular joint. Br J Radiol 66:108-111
  7. Thomason PA, Linson MA (1986) Isolated dislocation of the proximal tibiofibular joint. J Trauma 26:192-195
  8. Schønnemann JO, Brix M (2012) Proximal tibiafibular joint dislocation with total syndesmotic rupture. Inj Extra 43:137-138. doi:10.1016/j.injury.2012.07.186
  9. Aladin A, Lam KS, Szypryt EP (2002) The importance of early diagnosis in the management of proximal tibiofibular dislocation: a 9- and 5-year follow-up of a bilateral case. Knee 9:233-236
  10. Andersen K (1985) Dislocation of the superior tibiofibular joint. Injury 16:494-498
  11. Buse H, Stanković P, Kaessmann HJ (1973) Injury of proximal tibio-fibular joint. Archiv für orthopädische und Unfall-Chirurgie 76:25-30
  12. Ellis C (2003) A case of isolated proximal tibiofibular joint dislocation while snowboarding. Emerg Med J EMJ 20:563-564
  13. Falkenberg P, Nygaard H (1983) Isolated anterior dislocation of the proximal tibiofibular joint. J Bone Joint Surg Br 65:310-311
  14. Ginnerup P, Sørensen VK (1978) Isolated traumatic luxation of the head of the fibula. Acta Orthop Scand 49:618-620
  15. Horan J (2006) Proximal tibiofibular dislocation. Emerg Med J 23:e33-e33. doi:10.1136/emj.2005.032144
  16. Hsieh C-H (2009) Acute dislocation of the proximal tibiofibular joint. J Orthop Sports Phys Ther 39:2519. doi:10.2519/jospt.2009.0414
  17. Laing AJ, Lenehan B, Ali A, Prasad CVR (2003) Isolated dislocation of the proximal tibiofibular joint in a long jumper. Br J Sports Med 37:366-367
  18. Levy BA, Vogt KJ, Herrera DA, Cole PA (2006) Maisonneuve fracture equivalent with proximal tibiofibular dislocation. A case report and literature review. J Bone Joint Surg Am 88:1111-1116. doi:10.2106/JBJS.E.00954
  19. Love JN (1992) Isolated anterolateral proximal fibular head dislocation. Ann Emerg Med 21:757-759
  20. O'Rourke SK, McManus F (1982) Dislocation of the proximal tibio-fibular joint-a soccer injury? Ir J Med Sci 151:53-54
  21. Pekelharing JF, Van Der Woude P (2012) Diagnose in beeld Een man met een verdraaide knie. 4197
  22. Petter A, Davidson J (2004) An unusual knee injury: isolated tibiofibular dislocation. Emerg Med Australas EMA 16:172-173. doi:10.1111/j.1742-6723.2004.00572.x
  23. Pichler W, Schatz B, Gumpert R et al (2006) Isolated proximal tibiofibular dislocation in pregnancy after insignificant trauma. Inj Extra 37:241-243. doi:10.1016/j.injury.2005.12.016
  24. Rajkumar P, Schmitgen GF (2002) A new surgical treatment of an acute dislocation of the proximal tibiofibular joint. Int J Clin Pract 56:556-557
  25. Schuurhuizen C, Heetveld M, Driessen L (2012) Geïsoleerde dislocatie van het proximale tibiofibulaire gewricht. Nederlands Tijdschrift voor Traumatologie 20:124-127. doi:10.1007/s12506-012-0024-0
  26. Turco VJ, Spinella AJ (1985) Anterolateral dislocation of the head of the fibula in sports. Am J Sports Med 13:209-215
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