Introduction. Dislocation of the proximal tibiofibular joint is a rare
injury. It occurs during a sports activity that includes rough twisting
movements of the bent knee. The role of the proximal tibiofibular joint is to
reduce torsional loads to the ankle, to distribute the bending moment of the
outer side of tibia, and transfer the vertical load while standing. In the
literature there is no larger series; only several cases of the proximal
tibiofibular joint dislocation treated by different methods have been
published so far. Case Report. A 23-year-old male soccer player sustained an
injury after he had joined the game without previous warming-up. He fell on
his right side because of a sudden change of direction while his foot was
fixed to the base. He felt a severe pain and had a sensation as if something
had snapped in his right knee. Pain and swelling at the head of fibula were
found by physical examination, which, however, did not reveal any pain,
swelling and instability of the ankle or peroneal nerve palsy. The x-ray
showed anterolateral dislocation of the proximal tibiofibular joint, Ogden
type II. Since manual reposition in general anesthesia failed, open reduction
internal fixation was performed and proximal tibiofibular joint was
transfixed with a screw. After the wound closure, the above-the-knee plaster
cast was applied. The screw was extracted six weeks later, full weight
bearing was allowed and he started with physical therapy. Four months after
the injury he returned to sports activities. On the follow- up one year after
the injury he had the full range of motion of the knee, no complains, and
continued with active soccer playing. X-ray showed no signs of arthrosis of
the proximal tibiofibular joint. Conclusion. The proximal tibiofibular joint
dislocation may be the cause of the chronic pain of the knee so it has to be
taken into account when making differential diagnosis in case of the pain at
the lateral side of the knee. The key for making the accurate diagnosis is
the technically correct X-ray of the injured knee compared with the opposite
one, showing the displacement of fibular head. If manual reposition fails,
open reduction internal fixation and screw transfixation of the proximal
tibiofibular joint allow good results and fast return to sport activities.
An isolated proximal tibiofibular joint dislocation in a young male playing soccer: a case report