gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2015)

20.10. - 23.10.2015, Berlin

A review of proximal tibiofibular joint dislocations

Meeting Abstract

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  • presenting/speaker James Perry - Royal Liverpool Hospital, Liverpool, United Kingdom
  • Matthew Freudmann - Furness General Hospital, Barrow in Furness, United Kingdom

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2015). Berlin, 20.-23.10.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocPO28-20

doi: 10.3205/15dkou804, urn:nbn:de:0183-15dkou8048

Veröffentlicht: 5. Oktober 2015

© 2015 Perry et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe



Objectives: Case reports have been published detailing this rarely diagnosed pathology, however an extensive review article has not been published since 1974 (Ogden et al.). The tibiofibular joint is a synovial joint found between the lateral tibial condyle and the fibular head. The joint may be classified as either oblique or horizontal. Its purpose is to dissipate lower leg torsional stresses and lateral tibial bending movements; it is also involved in transmitting axial loads during weight bearing. Four classes of dislocation may occur and are more common (70%) in an oblique joint; subluxation, anterolateral, posteromedial, and superior. Each of these variations have differing aetiological mechanisms and clinical features, although sporting injury is the most common cause. Common symptoms include lateral knee pain, difficulty weight bearing, a bony prominence over the lateral aspect of the knee, a 'click/pop' on movement, and increased knee pain when moving the ankle.

An isolated proximal tibiofibular joint dislocation is uncommon and is encountered predominantly in athletes whose sports require twisting motions of a flexed knee (e.g. skiing, rugby, football, basketball). Interestingly it appears that anterolateral dislocations are rare in football (soccer) players as there is limited literature surrounding this scenario.

Methods: A systematic literature review of a topic that has not been explored in recent times.

Results and Conclusion: It is key to diagnose and manage the pathology rapidly. Nonsurgical management is usually successful and closed reduction should be attempted primarily but controversy exists regarding the necessary period of immobilisation. If this is unsuccessful open reduction is warranted, with particular care being taken not to damage the peroneal nerve. There are several ways of performing open reduction; the majority of surgeons prefer to stabilise the reduction using Kirschner-wires (K-wire) or a screw, some use bioabsorbable pins or a 'tightrope' system. No consensus exists as to an optimal rehabilitation programme. If chronic dislocation ensues conservative management should be trailed initially, surgical correction using arthrodesis of the proximal tibiofibular joint coupled with fibular osteotomy may then be implemented, although minimal literature exists regarding this topic. Resection of the fibular head or anatomical (soft tissue) reconstruction are other options available to surgeons at this stage.