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DOI: 10.1055/s-0042-1743284
The Floating Fibula: Outcome of Pure Tibiotalar Dislocation with Lesion to the Proximal Tibiofibular Joint: Case Report
Article in several languages: español | English
Abstract
Background Floating fibula after high-energy trauma is a very uncommon entity. The present is the first report of a case associated with avulsion of the bicipital tendon.
Purpose To present a case of floating fibula after divergent ankle dislocation associated with proximal peroneal dislocation.
Materials and methods A 17-year-old woman who fell after a traffic accident and presented pain and deformity of the left ankle with pain and functional impotence in the ipsilateral knee. The radiographs showed a pure divergent type-IV left-ankle dislocation. Closed reduction was performed in the emergency room. The study was complemented with a magnetic resonance imaging scan which showed complete rupture of the syndesmosis and the deltoid ligament, as well as a non-displaced fracture of the external tibial plateau together with a tear of the proximal tibiofibular capsule and complete detachment of the external lateral ligament and bicipital tendon from its insertion in the peroneal head.
The syndesmosis and deltoid ligament were reanchored, as well as the external lateral ligament and the bicipital tendon, using metallic bone anchors and fibula reduction both proximally and distally, using a suture-button system. The patient was immobilized with a long-leg splint for four weeks.
Results The patient presented complete recovery of strength at five months of follow-up.
Conclusion Floating fibula is a rare entity, with only one case described in the literature. It involves a disruption of the proximal and distal tibiofibular joint, which can lead to knee and ankle instability.
Therefore, in cases of high-energy trauma to the ankle, a careful examination of the ipsilateral knee is necessary.
Publication History
Received: 16 October 2021
Accepted: 10 December 2021
Article published online:
14 June 2022
© 2022. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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