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J Knee Surg
DOI: 10.1055/a-2315-7691
Original Article

Isolated, Proximal Tibiofibular Injuries in Athletic Patients: A Critical Analysis Review

Derrick M. Knapik 
1   Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri
2   School of Medicine, Washington University in St. Louis, St. Louis, Missouri
,
Varun Gopinatth
3   St. Louis University School of Medicine, St. Louis, Missouri
,
Garrett R. Jackson
4   Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush University, Chicago, Illinois
,
Robert F. LaPrade
5   Twin Cities Orthopaedics, Edina, Minnesota
,
Jorge Chahla
4   Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush University, Chicago, Illinois
,
Robert H. Brophy
1   Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri
2   School of Medicine, Washington University in St. Louis, St. Louis, Missouri
,
Matthew J. Matava
1   Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri
2   School of Medicine, Washington University in St. Louis, St. Louis, Missouri
,
Matthew V. Smith
1   Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri
2   School of Medicine, Washington University in St. Louis, St. Louis, Missouri
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Abstract

While infrequently reported, isolated injuries to the proximal tibiofibular (TF) joint primarily occur in young, athletic patients participating in sporting activities requiring explosive, high-impact movements, increasing the risk for potential twisting injuries, especially across a hyperflexed knee. The proximal TF joint is stabilized by bony, muscular and ligamentous structures, including both the anterior and posterior proximal TF complexes, with the anterior complex providing more robust stability. Proximal TF injuries frequently involve anterior and lateral displacement of the proximal fibula relative to its native articulation with the tibia. Proper diagnosis is dependent on careful and meticulous history and physical examination, as missed injuries are common, leading to the potential for continued pain, weakness and disability, especially in athletic patients. While spontaneous joint reduction has been reported, injuries may require formal closed reduction, with irreducible and chronic injuries requiring open reduction and stabilization, with recent investigations reporting satisfactory outcomes following anatomic reconstruction of the proximal TF ligament.

Keywords

sports medicine - knee - proximal tibiofibular joint


Publication History

Received: 13 August 2023

Accepted: 23 April 2024

Accepted Manuscript online:
27 April 2024

Article published online:
30 May 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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