Proximal tibiofibular dislocation: a case report of this often overlooked injury

Martin, Benjamin; Corbett, James R.; Littlewood, A. H. M.; Clifton, R.

doi:10.1259/bjrcr.20150372

Cited by 3 publications

(4 citation statements)

References 16 publications

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Section: Discussionmentioning

confidence: 99%

“…Traumatic PTFD is relatively uncommon and sparsely reported in literature, except for case reports [1,3,10,14,[17][18][19]. Due to insufficient awareness, PTFD is easily overlooked or missed [3,18]. A retrospective study conducted by Herzog et al showed that incidence of proximal tibiofibular dislocation in tibial plateau fractures and tibial shaft fractures was only 1-2% [15].…”

Section: Discussionmentioning

confidence: 99%

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Traumatic proximal tibiofibular fracture and dislocation

Li,

Tian,

Fei

et al. 2024

BMC Musculoskelet Disord

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Background Traumatic proximal tibiofibular fracture and dislocation (PTFD) have been rarely studied and are easily missed in clinical practice. PTFD is considered a marker of severely traumatized knees. The purpose of this study was to retrospectively analyze the incidence and impact of PTFD in traumatized knees with vascular injury. Methods Patients with knee trauma and vascular injury were included from January 2022 to October 2023. X-rays and CT scans of included patients were retrospectively analyzed to determine the presence of PTFD. Patients were further divided into PTFD group and non-PTFD group for further comparative analysis. Results A total of 27 patients (28 limbs) were included. Incidence of PTFD was 39.3% (11/28) in traumatic knee with vascular injury, including 8 anterolateral dislocations and 3 posteromedial dislocations. PTFD group had significantly more limbs with open injuries compared with non-PTFD group (10/11 VS 7/17, p<0.05). Amputation rate of PTFD group was as high as 40% (4/10), compared to 23.5% (4/17) in non-PTFD group. However, the difference between two groups was not statistically significant (p>0.05). Conclusions PTFD was easily overlooked or missed. In traumatized knees with vascular injury, incidence of PTFD was high. The presence of PTFD might indicate severe knee trauma and the possibility of open injury. Although there was no significant difference compared with non-PTFD group, PTFD group had a relatively high amputation rate of 40%.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Traumatic proximal tibiofibular fracture and dislocation

Li,

Tian,

Fei

et al. 2024

BMC Musculoskelet Disord

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“…In addition, the most common fracture morphology associated with proximal tibiofibular injury was a tibial shaft fracture (Figure 2 ) (68.75%), which is consistent with previous studies. 10 , 21 Of the many case reports published on this topic, 9 10 11 12 13 14 15 16 17 18 19 20 21 this systematic review was only able to identify three larger case series that have published the epidemiology of these injuries. Herzog et al 2 published a similarly high rate of open fracture (76.7%) and peroneal nerve palsy (36%) with their series of 30 proximal tibiofibular injuries; however, their rate of vascular injury was lower at 6.7%.…”

Section: Discussionmentioning

confidence: 99%

“… 3 4 5 6 7 8 There is overall a paucity of literature on traumatic dislocations of the proximal tibiofibular joint, although a few small case studies have been reported. 9 10 11 12 13 14 15 16 17 18 19 20 21 There is similarly no systematic review of the literature on this topic.…”

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confidence: 99%

Traumatic Dislocation of the Proximal Tibiofibular Joint: A Systematic Review and 10-year Experience From a Level 1 Trauma Center

2022

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Introduction:Traumatic proximal tibiofibular joint dislocations occur infrequently and are typically the result of high-energy trauma. These injuries can be a marker of limb injury severity because patients often sustain vascular injury and are at high risk of amputation. The purpose of this study was to present a systematic review of traumatic proximal tibiofibular joint dislocations and compare rates of associated injuries with a retrospective series of patients at a level 1 trauma center. The secondary objective was to report rates and clinical predictors of limb amputation.Methods:A systematic review was conducted, identifying three studies meeting eligibility criteria. A retrospective chart review was conducted identifying 17 skeletally mature patients with proximal tibiofibular dislocation treated from January 2010 to February 2021. A chart review extracted patient demographics, fracture patterns, open fracture, preoprative and postoperative peroneal nerve injury, vascular injury, and amputation. Binary logistic regression analysis was used to identify clinical predictors of outcomes.Results:Sixteen of 17 proximal tibiofibular injuries (94.1%) were associated with fracture, most commonly tibial shaft (n = 11, 68.75%). Twelve of 17 fractures (76.5%) were open. Five vascular injuries (29.4%) occurred requiring surgical intervention. Seven (41.2%) preoperative peroneal nerve deficits were noted; six had persistent deficits postoperatively or underwent amputation (average follow-up 31.3 ± 32.6 months). Two patients in the sample without preoperative peroneal nerve deficits were noted to exhibit them after fixation. Eight patients (47%) underwent an amputation, 7 (87.5%) of whom had an open fracture and 4 (50%) of whom had documented vascular injury.Discussion:Traumatic proximal tibiofibular fractures indicate severe injury to the lower extremity with high risk for nerve injury and possible amputation. Patients who present with vascular injury and open fracture in association with proximal tibiofibular joint disruption may be at elevated risk of amputation.

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Proximal tibiofibular joint dislocation

Feger¹

2021

Radiopaedia.org

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Proximal tibiofibular dislocation: a case report of this often overlooked injury

Cited by 3 publications

References 16 publications

Traumatic proximal tibiofibular fracture and dislocation

Traumatic proximal tibiofibular fracture and dislocation

Traumatic Dislocation of the Proximal Tibiofibular Joint: A Systematic Review and 10-year Experience From a Level 1 Trauma Center

Proximal tibiofibular joint dislocation

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