Rare Joint Injury ReportedInjury to the proximal tibiofibular joint is rare, or perhaps just rarely reported. "Proximal" describes the place where the two bones of the lower leg (the tibia and the fibula) meet at the knee. This article reviews injuries at this joint.
There are strong ligaments around the joint to hold the bones together and reinforce the joint. Several different injuries can occur to disrupt this joint. One of the ligaments or muscles can be torn. The joint can be dislocated. Nerve tissue can be stretched or injured.
Some injuries are caused by trauma. Others occur without trauma or injury, such as when there is overall tissue looseness (called laxity). Two other risk factors increase the chances of a proximal tibiofibular injury.
When the knee is bent, one of the protective ligaments is more relaxed. A twisting force when the knee is in this position is more likely to cause injury than when the knee is straight. The natural shape and angle of the joint from birth can also increase the risk of injury.
Since this injury is rare, it can be easily missed. The symptoms include pain and a bump or swelling along the outside of the knee. Putting weight on the leg is painful, especially when climbing stairs. Some patients only have trouble during sports movements that require a sudden change in direction.
Doctors must sort out a tibiofibular injury from damage to the knee joint or soft tissues around the knee. A careful examination of the ankle, tibiofibular joint, and knee usually brings about a correct diagnosis. X-rays can give some extra information.
This condition may get better in children as they mature. For children, teens, and adults, treatment can include changing the way activities are done, using supportive straps, and doing muscle strengthening. For a chronic problem that doesn't go away, surgery may be needed.
Jon K. Sekiya, MD, and John E. Kuhn, MD. Instability of the Proximal Tibiofibular Joint. In Journal of the American Academy of Orthopaedic Surgeons. March/April 2003. Vol. 11. No. 2. Pp. 120-128.
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