Eur J Pediatr Surg 2009; 19(6): 413-416
DOI: 10.1055/s-0029-1202777
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Traumatic Dislocation of the Fibula Head in Childhood and Adolescence: Operative Therapy and Outcome of a Rare Injury

T. Vogel 1 , M. Baumann 1 , J. Rether 1 , F. Stuby 1 , K. Weise 1 , A. Badke 1
  • 1Berufsgenossenschaftliche Unfallklinik, Klinik für Unfall- und Wiederherstellungschirurgie, Tübingen, Germany
Further Information

Publication History

Publication Date:
09 April 2009 (online)

Introduction

Dislocation of the fibular head in children is a very rare injury, and only two previous cases have been reported [1] [2] [3] [4]. In an emergency room setting, this rarity can lead to difficulties in diagnosis and consequently may cause severe problems [5]. The mechanism of dislocation of the fibula head without an accompanying injury of the bone or ligaments has not been exactly determined. A complex distortion-flexion-mechanism has been discussed [4], but direct trauma can also lead to this injury [6] [7] [8]. Horan describes a drop on a flexed knee combined with plantar flexion and inversion of the foot [9].

References

  • 1 Parkes 2nd JC, Zelko RR. Isolated acute dislocation of the proximal tibiofibular joint. Case report.  J Bone Joint Surg Am. 1973;  55 177-183
  • 2 Peregalli PF. Isolated luxation of the peroneal head.  Arch Ortop. 1955;  68 355-366
  • 3 Saurenmann P, Marty A. Isolated traumatic dislocation of the head of the fibula.  Helv Chir Acta. 1994;  60 843-845
  • 4 Turco VJ, Spinella AJ. Anterolateral dislocation of the head of the fibula in sports.  Am J Sports Med. 1985;  13 209-215
  • 5 Aladin A, Lam KS, Szypryt EP. The importance of early diagnosis in the management of proximal tibiofibular dislocation: a 9- and 5-year follow-up of a bilateral case.  Knee. 2002;  9 233-236
  • 6 Ellis C. A case of isolated proximal tibiofibular joint dislocation while snowboarding.  Emerg Med J. 2003;  20 563-564
  • 7 Falkenberg P, Nygaard H. Isolated anterior dislocation of the proximal tibiofibular joint.  J Bone Joint Surg Br. 1983;  65 310-311
  • 8 Maurer F. Die proximale tibiofibulare Verbindung und ihre biomechanische Bedeutung unter physiologischen und pathologischen Bedingungen – eine klinische und experimentelle Studie. In, Habilitationsschrift Universität Tübingen. Tübingen: Eberhard-Karls-Universität 1995
  • 9 Horan J, Quin G. Proximal tibiofibular dislocation.  Emerg Med J. 2006;  23 e33
  • 10 Dinkelaker F, Tiedtke R, Rahmanzadeh R. Dislocation of the head of the fibula – diagnostic and therapeutic problems.  Aktuelle Traumatol. 1985;  15 264-266
  • 11 Keogh P, Masterson E, Murphy B. et al . The role of radiography and computed tomography in the diagnosis of acute dislocation of the proximal tibiofibular joint.  Br J Radiol. 1993;  66 108-111
  • 12 Voglino JA, Denton JR. Acute traumatic proximal tibiofibular joint dislocation confirmed by computed tomography.  Orthopedics. 1999;  22 255-258
  • 13 Keene JS. Diagnosis of undetected knee injuries.  Interpreting subtle clinical and radiologic findings. Postgrad Med. 1989;  85 153-156 , 161–153
  • 14 Lyle HH. Traumatic Luxation of the Head of the Fibula.  Ann Surg. 1925;  82 635-639
  • 15 Ogden JA. Subluxation of the proximal tibiofibular joint.  Clin Orthop Relat Res. 1974;  56 192-197
  • 16 Ogden JA. The anatomy and function of the proximal tibiofibular joint.  Clin Orthop Relat Res. 1974;  101 186-191
  • 17 Ogden JA. Subluxation and dislocation of the proximal tibiofibular joint.  J Bone Joint Surg Am. 1974;  56 145-154
  • 18 Thomason PA, Linson MA. Isolated dislocation of the proximal tibiofibular joint.  J Trauma. 1986;  26 192-195
  • 19 Rajkumar P, Schmitgen GF. A new surgical treatment of an acute dislocation of the proximal tibiofibular joint.  Int J Clin Pract. 2002;  56 556-557
  • 20 Veth RP, Klasen HJ, Kingma LM. Traumatic instability of the proximal tibiofibular joint.  Injury. 1981;  13 159-164
  • 21 Kohler G, Nakhostin M, Herren T. Acute isolated ventral dislocation of the head of the fibula.  Unfallchirurg. 1996;  99 221-222
  • 22 Baciu CC, Olaru I, Tudor A. Idiopathic recurrent proximal tibiofibular dislocation in adults. 3 cases treated by an original surgical technic.  Rev Chir Orthop Reparatrice Appar Mot. 1983;  69 75-79
  • 23 Cazeneuve JF, Bracq H. Chronic instability of the proximal tibio-fibular articulation: hemi-long biceps ligamentoplasty by the Weinert and Giachino technique. Apropos of 3 cases.  Rev Chir Orthop Reparatrice Appar Mot. 1998;  84 84-87
  • 24 Miettinen H, Kettunen J, Vaatainen U. Dislocation of the proximal tibiofibular joint. A new method for fixation.  Arch Orthop Trauma Surg. 1999;  119 358-359
  • 25 Stepanova AA. A method of fixation of posterior dislocation of the head of the fibula.  Ortop Travmatol Protez. 1989;  7 56-57

Correspondence

Dr. T. VogelMD 

Berufsgenossenschaftliche Unfallklinik

Klinik für Unfall- und Wiederherstellungschirurgie

Schnarrenbergstr. 95

72076 Tübingen

Germany

Phone: +49/0/70 71 60/63/810

Fax: +49/0/70 71 60 61 002

Email: tvogel@bgu-tuebingen.de

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