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

Derrick M. Knapik; Varun Gopinatth; Garrett R. Jackson; Robert F. LaPrade; Jorge Chahla; Robert H. Brophy; Matthew J. Matava; Matthew V. Smith

doi:10.1055/a-2315-7691

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2024; 37(11): 773-783
DOI: 10.1055/a-2315-7691

Original Article

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

Authors

Derrick M. Knapik

¹Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri

²School of Medicine, Washington University in St. Louis, St. Louis, Missouri
Varun Gopinatth

³St. Louis University School of Medicine, St. Louis, Missouri
Garrett R. Jackson

⁴Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush University, Chicago, Illinois
Robert F. LaPrade

⁵Twin Cities Orthopaedics, Edina, Minnesota
Jorge Chahla

⁴Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush University, Chicago, Illinois
Robert H. Brophy

¹Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri

²School of Medicine, Washington University in St. Louis, St. Louis, Missouri
Matthew J. Matava

¹Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri

²School of Medicine, Washington University in St. Louis, St. Louis, Missouri
Matthew V. Smith

¹Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri

²School of Medicine, Washington University in St. Louis, St. Louis, Missouri

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

Full Text

References

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