Traumatic Proximal Tibiofibular Dislocation

Abstract

Traumatic proximal tibiofibular dislocation is a rare injury that is often unrecognized or misdiagnosed at the initial presentation because of a lack of clinical suspicion. When diagnosed, the injury should be promptly reduced. Missed injuries or late presentations are a potential source of chronic morbidity. This article describes the relevant anatomy, classifications, and diagnostic and therapeutic approaches. The authors stress the importance of evaluating the distal syndesmotic ligaments and the interosseous membrane because the mechanism of trauma can also cause a disruption of the distal tibiofibular syndesmosis. In the presence of syndesmotic instability, prompt stabilization is advocated. Whether syndesmotic stabilization is indicated in cases of a syndesmotic sprain is controversial. An illustrative case is also presented of a 28-year-old male soccer player who sustained a proximal tibiofibular dislocation after a violent twisting motion of the right knee.