Dislocation of the fibular head in an unusual sports injury: a case report (original) (raw)

Acute proximal tibiofibular joint dislocation: a sports related injury?—two different cases

Annals of Joint

Proximal tibiofibular joint (PTFJ) dislocation is a rare injury, accounting for less than 1% of all knee injuries. The mechanism of this injury is usually sports related. Diagnosis is largely clinical, but the findings may be subtle. This condition may be easily missed. There is no larger series described in the literature but only several cases of dislocation of the PTFJ treated by different methods. We present two different antero-lateral dislocation cases successfully treated with different approaches.

Dislocation of the proximal tibiofibular joint

Archives of Orthopaedic and Trauma Surgery, 1999

Introduction. Dislocation of the proximal tibiofibular joint is a rare injury. It occurs during a sports activity that includes rough twisting movements of the bent knee. The role of the proximal tibiofibular joint is to reduce torsional loads to the ankle, to distribute the bending moment of the outer side of tibia, and transfer the vertical load while standing. In the literature there is no larger series; only several cases of the proximal tibiofibular joint dislocation treated by different methods have been published so far. Case Report. A 23-year-old male soccer player sustained an injury after he had joined the game without previous warming-up. He fell on his right side because of a sudden change of direction while his foot was fixed to the base. He felt a severe pain and had a sensation as if something had snapped in his right knee. Pain and swelling at the head of fibula were found by physical examination, which, however, did not reveal any pain, swelling and instability of the ankle or peroneal nerve palsy. The x-ray showed anterolateral dislocation of the proximal tibiofibular joint, Ogden type II. Since manual reposition in general anesthesia failed, open reduction internal fixation was performed and proximal tibiofibular joint was transfixed with a screw. After the wound closure, the above-the-knee plaster cast was applied. The screw was extracted six weeks later, full weight bearing was allowed and he started with physical therapy. Four months after the injury he returned to sports activities. On the follow-up one year after the injury he had the full range of motion of the knee, no complains, and continued with active soccer playing. X-ray showed no signs of arthrosis of the proximal tibiofibular joint. Conclusion. The proximal tibiofibular joint dislocation may be the cause of the chronic pain of the knee so it has to be taken into account when making differential diagnosis in case of the pain at the lateral side of the knee. The key for making the accurate diagnosis is the technically correct X-ray of the injured knee compared with the opposite one, showing the displacement of fibular head. If manual reposition fails, open reduction internal fixation and screw transfixation of the proximal tibiofibular joint allow good results and fast return to sport activities.

Acute traumatic proximal tibiofibular dislocation: Treatment of three cases

Journal of Orthopaedic Case Reports, 2019

Introduction: Acute traumatic dislocation of the proximal fibula occurs in an anterolateral, posteromedial, or superior direction. The dislocation is seen both isolated and in combination with other injuries of the leg. A dislocation is an uncommon injury. We have recently treated three patients with this injury which we believe will illustrate some treatment aspects. Case Reports: Case 1: A 25-year-old man fell in a football match. He had pain in his leg especially proximally. There was a prominent fibular head on inspection. X-rays showed an anterolateral dislocation in the proximal tibiofibular joint. The dislocation was treated by closed reduction under spinal anesthesia. The joint was stable when tested subsequently. He avoided weight bearing for 2 weeks. At 6 months follow-up, the patient played football at the same level. Case 2: A 63-year-old man caught his right foot in a net and fell immediate pain and minimal swelling proximally on the leg. It was diagnosed as a tibiofibu...

Isolated Traumatic Proximal Tibio-Fibular Joint Dislocation: Case Report of a Rare Injury

Journal of Universal College of Medical Sciences, 2015

We report a rare case of isolated traumatic anterolateral dislocation of proximal tibiofibular joint dislocation in a 41 year old female patient who was admitted in our institution following a twisting injury to knee. Initial clinical examination and plain radiographs were equivocal needing bilateral axial Computed Tomography (CT) scan for definite diagnosis. We discuss the various aspects of this rare injury including the current management options and clinical outcome.DOI: http://dx.doi.org/10.3126/jucms.v2i4.12066Journal of Universal College of Medical Sciences (2014) Vol.02 No.04 Issue 08Page: 37-40

Traumatic Proximal Tibiofibular Dislocation

The American Journal of Sports Medicine, 2008

Traumatic proximal tibiofibular dislocation is a rare injury that is often unrecognized or misdiagnosed at the initial presentation because of a lack of clinical suspicion. When diagnosed, the injury should be promptly reduced. Missed injuries or late presentations are a potential source of chronic morbidity. This article describes the relevant anatomy, classifications, and diagnostic and therapeutic approaches. The authors stress the importance of evaluating the distal syndesmotic ligaments and the interosseous membrane because the mechanism of trauma can also cause a disruption of the distal tibiofibular syndesmosis. In the presence of syndesmotic instability, prompt stabilization is advocated. Whether syndesmotic stabilization is indicated in cases of a syndesmotic sprain is controversial. An illustrative case is also presented of a 28-year-old male soccer player who sustained a proximal tibiofibular dislocation after a violent twisting motion of the right knee.

Modified technique of traetment for proximal tibiofibular joint dislocation

Vojnosanitetski pregled, 2017

Introduction. Dislocation of the proximal tibiofibular joint (PTFJ) is a rare injury. The diagnosis requires an accurate history of the mechanism and symptoms of the injury, and adequate clinical and radiographic evaluation of both knees. In the literature there is no larger series, only several cases of PTFJ dislocation treated by different methods have been published so far. The aim of the study was to present a modified technique for the treatment of the unstable PTFJ that results in faster recovery of the patient. Case report. A 24-year-old football player was injured at the beginning of training; when tackling the ball he felt a sharp pain in his right knee. He was immediately brought to the Emergency Center of Vojvodina and diagnosed with anterolateral dislocation of the PTFJ. Close reduction in general anesthesia was tried but we failed and then open reduction and internal fixation (ORIF) were performed with a single three cortical screw. We preferred not to immobilise the kn...

Proximal Tibiofibular Joint Dislocation as a Maissoneuve Equivalent Fracture

Foot & Ankle Orthopaedics, 2017

Category: Ankle, Trauma Introduction/Purpose: Dislocation of the proximal tibiofibular joint (PTFJ) in association with ankle fracture is an infrequent injury. The mechanism involves a pronation-external rotation injury in which the energy exits through the PTFJ instead of the proximal fibula, like in a Maissoneuve fracture. Early diagnosis and treatment is of paramount importance to avoid complications such as pain, posterolateral knee instability and peroneal nerve injury due to chronic traction by the dislocated fibular head. In addition, an anatomical reduction of the PTFJ is mandatory to restore the fibular length in order to obtain anatomic reduction at the ankle. The objective is to report 3 cases with PTFJ dislocation in association with ankle fracture and to provide a treatment guide based on the management of these patients. Methods: Three cases of PTFJ dislocation in association with ankle fracture, surgically treated in our institution between 2009 and 2016, were retrosp...

Joint Injuries Which Can Go Unnoticed : Fibular Head Dislocation

2017

INTRODUCTION Approximately 65% of the emergency cases are major and minor traumas. 35% of the unnoticed traumatic injuries are seen in the Emergency Departments. Unnoticed traumatic injuries adversely affects the patient’s prognosis, as well as tarnishing the reliability and reputation of the related clinician and institution [1]. Dislocation of the Proximal Tibiofibular Joint (PTFJ) is among the injuries that can go unnoticed [2]. While dislocation of the PTFJ is usually described with accompanying bone fractures in the literature [3], isolated dislocation of the PTFJ is very rare [4]. This study aims to report an isolated PTFJ dislocation case presenting to our Emergency Department with the complaint of knee pain due to falling while walking.