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Acta ortopédica mexicana
Print version ISSN 2306-4102
Abstract
CALVO, R et al. Proximal tibiofibular joint dislocation diagnosis and treatment. Acta ortop. mex [online]. 2021, vol.35, n.6, pp.560-566. Epub Oct 10, 2022. ISSN 2306-4102. https://doi.org/10.35366/105711.
Introduction:
Proximal tibiofibular joint dislocations (PTFJD) are uncommon and underdiagnosed injuries. Urgent reduction is mandatory to avoid chronic disfunction. The scarcely available literature does not present a unified management guideline. An acute PTFJD case report with spontaneous reduction and a review of the literature is presented, aiming to assist the diagnosis and management of this pathology.
Case report:
A 22-years old male presented to the emergency department with high intensity right knee pain after falling in a four-wheel motorcycle. The physical exam revealed a prominent painful mass on the lateral aspect of his knee and proximal leg. His range of motion and knee stability were unremarkable. X-rays were informed negative for musculoskeletal injuries. According to a sustained suspicion of PTFJD, the study was continued with a magnetic resonance imaging (MRI), which suggested PTFJD. During the following 24 hours, the patient referred he was entirely asymptomatic after feeling a loud «clank». He has been followed for three months with MRI, and remains asymptomatic with full functions.
Conclusion:
PTFJD diagnosis requires appropriate images. Urgent close reduction is mandatory; if unsuccessful, open reduction, primary repair and internal fixation are indicated. The prognosis of spontaneous reduction remains uncertain and requires a serial clinical evaluation. In the case of recurrence, the appropriate surgical management is indicated according to the elapsed time from the injury.
Keywords : Proximal tibio-fibular dislocation; treatment; spontaneous reduction; prognosis.