Isolated proximal tibiofibular joint dislocation in an elite rugby union player: Figure 1

MacGiobain, Sean; Quinlan, John; O’Malley, Natasha T.; Brophy, David P.; Quinlan, W.

doi:10.1136/bjsm.2007.043638

Cited by 13 publications

(30 citation statements)

References 10 publications

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“…Numerous case reports describe instability of the proximal tibiofibular joint. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Other studies describe specific techniques for ligamentous reconstruction of the proximal tibiofibular joint. [27][28][29][30] However, none of these reports provide detail regarding the anatomic location of the ligaments in association with known surrounding structures.…”

Section: Discussionmentioning

confidence: 99%

Anatomic Mapping for Surgical Reconstruction of the Proximal Tibiofibular Ligaments

See

Bear²,

Owens³

2013

Orthopedics

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Injury to the proximal tibiofibular joint is uncommon. Previous studies regarding the anatomy of this region have predominantly focused on joint orientation. As radiographic technology has advanced, later studies have attempted to evaluate the capsular anatomy. However, no reports specifically map the ligaments to this joint. The objectives of the current study were to define specific ligamentous structures that provide stability to the proximal tibiofibular joint, describe easily identifiable and reproducible surgical landmarks to aid in surgical reconstruction, and add to the understanding of the posterolateral structures of the knee previously described by other authors. The proximal tibiofibular joint ligaments were identified in 10 fresh-frozen cadaveric specimens. Average ligament length, width, and thickness and area of the footprints of the tibial and fibular attachments were measured. Distances from the ligament footprints to known anatomic landmarks (eg, Gerdy's tubercle, tibial articular surface, and fibular styloid) were also measured. The anterior ligament tibial attachment was a mean of 15.6 mm lateral and posterior to Gerdy's tubercle and 17.3 mm anterior and inferior from the fibular styloid. Posterior ligament tibial insertion was a mean of 15.7 mm inferior to the tibial articular surface on the tibial side and 14.2 mm medial and slightly inferior from the fibular styloid. Definable ligaments provide stability to the proximal tibiofibular joint and can be reconstructed in an anatomic fashion using the landmarks and parameters described. This information allows for an anatomic reconstruction of the proximal tibiofibular joint, which should provide patients with better outcomes and fewer postoperative sequelae.

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Section: Discussionmentioning

confidence: 99%

Anatomic Mapping for Surgical Reconstruction of the Proximal Tibiofibular Ligaments

See

Bear²,

Owens³

2013

Orthopedics

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“…MacGiobain et al 8 and Robinson et al 10 also reported a case of open reduction and internal fixation after an initial attempt with closed reduction failed. MacGiobain et al 8 reported the removal of the K wire 6 weeks after the surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Most dislocations can be treated through closed reduction; however, open reduction may be required in some cases due to an anterior muscle tension and/or interposition of disrupted capsular ligaments that may resist reduction 9. MacGiobain et al 8 and Robinson et al 10 also reported a case of open reduction and internal fixation after an initial attempt with closed reduction failed. MacGiobain et al 8 reported the removal of the K wire 6 weeks after the surgery.…”

Section: Discussionmentioning

confidence: 99%

Proximal tibiofibular joint dislocation treated using flexible and permanent syndesmosis fixation

Moscon¹,

Martimbianco

Duarte

et al. 2018

BMJ Case Reports

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We present the case of a 40-year-old man who suffered an isolated proximal tibiofibular dislocation of the left knee after a trauma during a soccer game. Physical examination and radiographic imaging revealed an anterolateral dislocation of the proximal fibula. The diagnosis was confirmed by MRI. The treatment choice was open reduction and internal fixation under direct visualisation using flexible and permanent internal fixation. Postoperative treatment includes knee immobilisation during the first week, and partial weight was allowed for 2 weeks progressing to full weight bearing over 4 weeks. The patient started a gradual and progressive physical therapy programme with range of motion exercises, muscle strengthening and gait training. Full knee range of motion was achieved after 4 weeks. No complaint of pain or hardware discomfort was reported, and the patient is back to daily life and sports activities after 6 months of surgical treatment.

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“…35,36 In the setting of PTFJ injury with intact tibiofibular ligaments, CT imaging can be limited as the subtle anterior migration of the fibula head is not always associated with lateral displacement and thus can lead to misdiagnosis. 10,35 In practice, it appears MRI is rarely required for diagnosis and should not delay definitive management in cases where X-ray and CT findings are suggestive of PTFJ dislocation. 10,35 In practice, it appears MRI is rarely required for diagnosis and should not delay definitive management in cases where X-ray and CT findings are suggestive of PTFJ dislocation.…”

Section: Factors Contributing Towards Ptfj Dislocation Includementioning

confidence: 99%

“…35 Only two cases in the literature progressed to MRI for diagnosis, one following an unsuccessful closed reduction and the other due to the radiation risk of CT in a pregnant patient. 10,35 In practice, it appears MRI is rarely required for diagnosis and should not delay definitive management in cases where X-ray and CT findings are suggestive of PTFJ dislocation.…”

Section: Factors Contributing Towards Ptfj Dislocation Includementioning

confidence: 99%

Review article: Isolated proximal tibiofibular joint dislocation

Cunningham

Farebrother

Miles

2018

Emerg Medicine Australasia

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Proximal tibiofibular joint (PTFJ) dislocations are relatively rare injuries and this paper provides an up-to-date review and practical management approach for the assessment and management of these cases. Isolated PTFJ dislocations are a rare injury, accounting for less than 1% of all knee injuries. Thus, there does not appear to be a clear consensus on definitive management and post-reduction care in the literature. This paper provides a review of the literature, anatomical analysis of the PTFJ in the dislocated state, and a technique for reduction. In the majority of cases, PTFJ dislocations are an injury that can be identified with simple imaging modalities and treated in the ED with manipulation under procedural sedation.

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Isolated proximal tibiofibular joint dislocation in an elite rugby union player: Figure 1

Cited by 13 publications

References 10 publications

Anatomic Mapping for Surgical Reconstruction of the Proximal Tibiofibular Ligaments

Anatomic Mapping for Surgical Reconstruction of the Proximal Tibiofibular Ligaments

Proximal tibiofibular joint dislocation treated using flexible and permanent syndesmosis fixation

Review article: Isolated proximal tibiofibular joint dislocation

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