Diaphyseal tibiofibular synostosis in professional athletes: Report of 2 cases

Abstract

Anterior leg pain is common in professional athletes and tibiofibular synostosis is reported to be a rare cause of anterior compartment pain or ankle pain related to sports activities. The management and appropriate treatment of this condition in professional athletes is controversial and the literature on the topic is sparse. Distal synostosis is usually related to ankle sprain and syndesmotic ligament injury, and proximal synostosis has been linked to leg length discrepancy and exostosis. Mid-shaft synostosis is even less common than proximal and distal forms. We present the treatment of mid-shaft tibiofibular synostosis in 2 cases of professional athletes (soccer and basketball player), along with a review of the literature. When diaphyseal synostosis is diagnosed, first-line conservative treatment, including ultrasound-guided steroid injection is recommended. However, if it does not respond to conservative management, surgical resection may be indicated to relieve symptoms.

Nonoperative Management of Proximal Tibiofibular Joint Synostosis after Tibial Intramedullary Nailing

“…Proximal tibiofibular joint (TFJ) synostosis, as a complication of trauma or surgery, is an exceptionally rare occurrence with few reports available in the literature [1–7]. The literature more commonly reports synostosis occurring in the radioulnar joint [8], the distal TFJ [9, 10], or the tibiofibular diaphyseal area [11]. It also highlights congenital abnormalities and immature skeletal development as a common cause of synostosis [4].…”

Tibiofibular Synostosis

“…A high risk of recurrence after surgical treatment has been reported, so meticulous attention should be given to hemostasis during surgery. A fractured synostosis and a recurrent compartment syndrome after a fractured synostosis have been reported as rare complications of the lesion [19][20][21][22][23][24][25][26][27][28].…”