Ogden JA. History and physical examination are very important for diagnosis. Anterolateral dislocation commonly stems from injury to the anterior and posterior capsular ligaments, and commonly the lateral collateral ligament.1,2 The common cause of traumatic anterolateral dislocation is a fall on a flexed knee, or a violent twisting motion during an athletic activity.3 The hyperflexed knee results in relaxation of the biceps femoris tendon and the lateral collateral ligament, and the violent twisting of the body creates a torque that pushes the fibular head laterally to the edge of the lateral tibial metaphysis.1,2 The forced plantar flexion and ankle inversion forces the laterally displaced fibular head anteriorly.1, The early recognition of instability in the proximal tibiofibular joint is necessary to optimize management of the injury and to avoid potential misdiagnosis. You can schedule an office consultation with Dr. LaPrade. Ma W, Wang F, Sun S, Ding L, Wang L, Yu T, Zhang Y. J Orthop Surg Res. Epub 2020 Feb 13. [Chronic instability of the proximal tibio-fibular articulation: hemi-long biceps ligamentoplasty by the Weinert and Giachino technique. The proximal tibiofibular joint should be palpated for tenderness, and laxity should be evaluated by translating the fibular head anteriorly and posteriorly with the thumb and index finger and asking the patient if the symptoms are reproduced or if there is any apprehension.4 The stability of the proximal tibiofibular joint is typically increased by full extension of the knee; if it is not, the lateral collateral ligament and posterolateral structures may also be injured. A fibular bone bruise (asterisk) is present near the attachment of the posterior ligament. The Proximal Tibiofibular Joint: A Biomechanical Analysis of the Anterior and Posterior Ligamentous Complexes. It often appears striated due to the presence of multiple bundles, and it is located just caudal to the anterior arm of the short head of the biceps femoris tendon. On the AP radiographs the right knee demonstrates decreased overlap between the fibular head and the lateral tibial condyle compared with the left indicating that the fibular head is displaced laterally. Injuries to the joint are more commonly atraumatic and should be treated with surgery only after all other therapies have been exhausted. The proximal tibiofibular joint is a synovial joint that functions in dissipating lower leg torsional stresses and lateral tibial bending moments and in transmitting axial loads in weight-bearing [ 1 ]. Flexing the knee to 90 degrees to relax the lateral collateral ligament and biceps femoris tendon, then moving the fibular head anteriorly and posteriorly, can test instability of the joint. Proximal Tibiofibular Joint Instability and Treatment - PubMed AJR Am J Roentgenol. A prospective study of normal knees and knees with surgically verified grade III injuries.
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