Proximal tibiofibular joint dislocation A case report

Proximal tibiofibular joint dislocation is a rare injury. Four types of proximal tibiofibular disruptions were found and they were classified as subluxation, anterolateral dislocation, posteromedial dislocation and superior dislocation. Idiopathic dislocation of proximal end of fibula appeared to be a self-limited condition of youth with decreasing symptoms as the patient approached skeletal maturity. Anterolateral dislocation was the most common injury encounter 85.Unfortunately the diagnosis was missed in about one third of cases. Most of the cases respond well by closed reduction. If chronic dislocation develops then arthrodesis or resection of proximal end of fibula can be done surgically. Postero-medial dislocation is proved more unstable after initial reduction. Mechanism of injury in this type is sudden internal rotation and plantar flexion of foot with external rotation of leg and flexion of knee. This injury may be associated with transient peroneal nerve palsy. Early diagnosis and management is the important factor in final outcome. All cases of lateral knee pain and history suggesting of proximal tibiofibular joint injury should raise clinical suspicion. Plain radiograph of both knee used as first imaging modality. Computer tomography is indicated if there is diagnostic uncertainty.