Proximal tibiofibular joint: Rendezvous with a forgotten articulation
| Autor: | Amitav Sarma, Bishwajeet Saikia, Bhaskar Borgohain |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty knee injuries Review Article medicine.disease_cause Weight-bearing lcsh:Orthopedic surgery Synovial joint Medicine Biomechanics Orthopedics and Sports Medicine Fibula mesh:dislocation dislocation business.industry Fibular collateral ligament mesh:Biomechanics musculoskeletal system medicine.disease knee injury Polytrauma Surgery lcsh:RD701-811 proximal tibiofibular joint Mesh terms: Biomechanics medicine.anatomical_structure Orthopedic surgery proximal tibiofibular joint Ankle business dislocations mesh:knee injuries |
| Zdroj: | Indian Journal of Orthopaedics Indian Journal of Orthopaedics, Vol 49, Iss 5, Pp 489-495 (2015) |
| ISSN: | 1998-3727 0019-5413 |
| DOI: | 10.4103/0019-5413.164041 |
| Popis: | The proximal tibiofibular joint (PTFJ) is a plane type synovial joint. The primary function of the PTFJ is dissipation of torsional stresses applied at the ankle and the lateral tibial bending moments besides a very significant tensile, rather than compressive weight bearing. Though rare, early diagnosis and treatment of the PTFJ dislocation are essential to prevent chronic joint instability and extensive surgical intervention to restore normal PTFJ biomechanics, ankle and knee function, especially in athletes prone to such injuries. PTFJ dislocations often remain undiagnosed in polytrauma scenario with ipsilateral tibial fracture due to the absence of specific signs and symptoms of PTFJ injury. Standard orthopedic textbooks generally describe no specific tests or radiological signs for assessment of the integrity of this joint. The aim of this paper was to review the relevant clinical anatomy, biomechanics and traumatic pathology of PTFJ with its effect on the knee emphasizing the importance of early diagnosis through a high index of suspicion. Dislocation of the joint may have serious implications for the knee joint stability since fibular collateral ligament and posterolateral ligament complex is attached to the upper end of the fibula. Any high energy knee injury with peroneal nerve palsy should immediately raise the suspicion of PTFJ dislocation especially if the mechanism of injury involved knee twisting in flexion beyond 80° and in such cases a comparative radiograph of the contralateral side should be performed. Wider clinical awareness can avoid both embarrassingly extensive surgeries due to diagnostic delays or unnecessary overtreatment due to misinformation on the part of the treating surgeon. |
| Databáze: | OpenAIRE |
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