Proximal tibiofibular joint dislocation treated using flexible and permanent syndesmosis fixation

Moscon, Antonio Carlos; Martimbianco, Ana Luiza Cabrera; Duarte, Aires; Gracitelli, Guilherme Conforto

doi:10.1136/bcr-2017-222843

Cited by 9 publications

(31 citation statements)

References 12 publications

(8 reference statements)

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“…Due to heterogeneity and scant evidence, there is currently no consensus on the definitive study and management of DPTJ [7]. As described in this case, most authors agree that clinical suspicion must be thorough and be confirmed with images, starting with radiography, and complementing with CT if suspicion persists [8,9]. However, magnetic resonance can also be helpful in differential diagnosis or in chronic cases [7].…”

Section: Discussionmentioning

confidence: 99%

Anterior Dislocation of the Tibiofibular Joint: A Case Report

González‐Arroyave¹,

Duque²,

Velez³

et al. 2023

Cureus

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Dislocation of the proximal tibiofibular joint (PTJ) is a knee injury that occurs infrequently. In this case, the dislocation of the PJT of the right knee was reported with subsequent pain and limitation in range of motion, caused by trauma during the practice of a soccer game. An intense pain was observed in the area where the head of the fibula is located without finding crepitation or deformity. Initially, comparative anteroposterior and lateral X-rays of the knees were requested, showing proximal tibiofibular joint incongruity with anterolateral displacement without evidence of fracture lines. For this reason, it was decided to take a tomography of the right knee that confirmed the presence of anterior dislocation of the proximal tibiofibular joint. Closed reduction under sedation was scheduled.

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Section: Discussionmentioning

confidence: 99%

Anterior Dislocation of the Tibiofibular Joint: A Case Report

González‐Arroyave¹,

Duque²,

Velez³

et al. 2023

Cureus

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“…However, flexible suture fixation could be considered for the PTFJ and/or syndesmosis. Flexible fixation for either isolated PTFJ injuries or combined PTFJ with syndesmosis injuries has been described 8,9 . Although Fig.…”

Section: Discussionmentioning

confidence: 99%

Treatment and Outcome of a “Floating Fibula” Injury

Joseph

Morgan

Mutty

2023

JBJS Case Connector

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Case:We report a case of a rare “floating fibula” ankle injury characterized by dislocation of the proximal tibiofibular joint (PTFJ), syndesmosis disruption, complete deltoid disruption, and tibiotalar dislocation without fibula fracture in a 44-year-old man. Imaging includes preoperative and postoperative radiographs and CT scans. Treatment involved reduction and screw fixation of the syndesmosis and PTFJ with planned screw removal. A successful clinical and radiographic outcome was achieved at the 15-month follow-up.Conclusion:This case highlights the unique features of the “floating fibula” injury and shows that reduction and intraoperative assessment may be more challenging than a typical Maisonneuve injury.

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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 treated using flexible and permanent syndesmosis fixation

Cited by 9 publications

References 12 publications

Anterior Dislocation of the Tibiofibular Joint: A Case Report

Anterior Dislocation of the Tibiofibular Joint: A Case Report

Treatment and Outcome of a “Floating Fibula” Injury

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

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