Modified technique of the treatment for proximal tibiofibular joint dislocation

Nemanja M Gvozdenović; Katarina Gvozdenović; Mirko Obradović; Milan Stanković

doi:10.2298/VSP150318177G

Nemanja M Gvozdenović Univerzitet u Novom Sadu, Medicinski fakultet, Klinički Centar Vojvodina, Klinika za ortopediju i traumatologiju
Katarina Gvozdenović Department of Radiology, Clinical Centre of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Mirko Obradović Department of Orthopedic Surgery and Traumatology, Clinical Centre of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Milan Stanković Department of Orthopedic Surgery and Traumatology, Clinical Centre of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia

DOI: https://doi.org/10.2298/VSP150318177G

Keywords: knee dislocation, joint instability, diagnosis, orthopedic procedures, treatment outcome,

Abstract

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.

Author Biography

Nemanja M Gvozdenović, Univerzitet u Novom Sadu, Medicinski fakultet, Klinički Centar Vojvodina, Klinika za ortopediju i traumatologiju

Srbija

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