Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 3)
Modified technique of the treatment for proximal tibiofibular joint dislocation
Authors:
Nemanja Gvozdenović, Katarina Gvozdenović , Mirko Obradović, Milan Stanković
Introduction. Dislocation of the proximal tibiofibular joint(PTFJ) is a rare injury. The diagnosis requires an accurate
history of the mechanism and symptoms of the injury, and
adequate clinical and radiographic evaluation of both knees. In
the literature there is no larger series, only several cases of
PTFJ dislocation treated by different methods have been published
so far. The aim of the study was to present a modified
technique for the treatment of the unstable PTFJ that results in
faster recovery of the patient. Case report. A 24-year-old football
player was injured at the beginning of training; when tackling
the ball he felt a sharp pain in his right knee. He was
immediately brought to the Emergency Center of Vojvodina
and diagnosed with anterolateral dislocation of the PTFJ. Close
reduction in general anesthesia was tried but we failed and then
open reduction and internal fixation (ORIF) were performed
with a single three cortical screw. We preferred not to immobilise
the knee after the procedure and immediately employed
passive and active exercises in the knee, without bearing weight
to the injured leg. After 6 weeks we removed the screw and gave
full weight support to the leg and continued physical treatment.
Conclusion. In case of acute PTFJ dislocation, the first
method of choice is closed reduction in sedation or general
anesthesia. If closed reduction fails, ORIF must be performed.
ORIF without immobilization and early start of physical
therapy lead to the rapid return to sports activities.