THE DIFFICULTY OF THE DIAGNOSIS OF AN ISOLATED PROXIMAL TIBIOFIBULAR JOINT DISLOCATION: A CASE REPORT AND REVIEW OF LITERATURE

Öz

lntroduction: An isolated dislocation of the proximal tibiofibular joint is uncommon injury.The diagnosis can be easily missed. in this case report, we expose how avoid missing out on thediagnosis and we expose a special maneuverwhich facilitating the open reduction.

Case Report: We report the case ofa 31-year-old man presented at emergency aft er right knee during football game. lniti ally ph ysical examination objectives a moderate swelling and a local pain on the lateral side of the right knee. The anteroposte rior and lateral radiograph s was considered normal. The diagno sis o f lateral meniscal injury was admitt ed. After one week, reexami nation objective a tender bony prominence over the antero lateral aspect of the knee. Radiol ogical investigations confirms the diagnosis of a proximal tibiofibular dislocation. An open reduction was performed. At final follow-up, the patie nt don't presents any complaints, with complete range of motion ofthe knee and the ankle.

Conclusion: The pro ximal tibiofibular joint dislocation is rare entity. The early diagno sis can be missed easily if no awareness of thi sinjury is present. The clinical presentation can mimes a lateral meniscal or lateral ligaments injuries. CT cofirm s d iagnosis if X-r ay are insuffisent. 

Often, early diagnosis allow s a closed reduction without surgery.

Anahtar Kelimeler

• TIBIOFIBULAR JOINT DISLOCATION,emergency service

Kaynakça

1. 1. Nelaton A. Elements de pathologie chirurgicale. Paris: Balliere; 1874;292.
2. 2. Keogh P, Masterson E, Murphy B, McCoy CT, Gibney RG, Kelly E. The role of radiography and computed tomography in the diagnosis of acute dislocation of the proximal tibiofibular joint. Br J Radiol. 1993; 66:108-11.
3. 3. Voglino JA, Denton JR. Acute traumatic proximal tibiofibular dislocation confirmed by computed tomography. Orthopedics. 1999;22:255-58.
4. 4. Love JN. lsolated anterolateral proximal fibular head dislocation . Ann Emerg Med. 1992;21:757-9.
5. 5. Aladin A, Lam KS, Szypryt EP. The impo rtance of early diagnosis in the management of proximal tibiofibular dislocation: a 9- and 5-year follow-up ofa bilateral case. Knee. 2002; 9: 233-6.
6. 6. Ogden JA. The anatomy and function of the proximal tibiofibular joint. ClinOrthop Relat Res.1974; 101:186-191.
7. 7. Laing AJ, Lenehan B, Ali A, Prasad CVR. lsolated dislocation of the proximal tibiofibular joint in a long jumper. Br J Sports Med.2003; 37:366-7.
8. 8. Ellis C: A case of isolated proximal tibiofibular joint dislocation while snowboarding. Emerg Med J. 2003; 20:563-4.

9. 9. Robinson Y, Reinke M, Heyde CE, Ertel W, Oberholzer A. Traumatic proximal tibiofibular joint dislocation treated by epen reduction and temporary fixatio n: a case report. Knee Surg Sports Traumatol Arthrosc. 2007; 15:199-201.
10. 1O. Veerappa LA, Gopalakrishna C. Traumatic proximal tibiofibular dislocation with neurovascular injury. indian J Orthop.2012;46: 585- 588.
11. 11. Capps GW, Hayes CW. Easily missed injuries around the knee. Radiog raphics. 1994; 14:1191-121 O.
12. 12. Nieuwe Weme R. A., Somford M. P., Schepers T. Proximal tibiofibular dislocation: a case report and review of literature. Strat Traum Limb Recon. 2014; 9:185-189.
13. 13. Semonian RH, Denlinger PM, Duggan RJ. Proximal tibiofibular subluxation relationship to lateral knee pain: a review of proximal tibiofibular joint pathologies. J Orthop Sports Phys Ther. 1995; 21:248- 57.
14. 14. Van den Bekerom MPJ, Weir A, van der Flier RE. Surgical stabilisation of the proximal tibiofibular jointusing temporary fixation. Acta Orthop Belg. 2004; 70:604-8.