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

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 tibiofibular 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.

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DMK:Arthrex Inc (grant support); Smith & Nephew (education); Elite Orthopaedics (education) VG: None GJ: None RFL: Smith & Nephew (consultant, royalties, education), Foundation Medical, LLC (educational support), Arthrex, Inc. (Royalties), Linvatec Corp. (speaking fees), JC: Smith & Nephew (consultant, royalties, education), MedWest Associates (education), RTI Surgical, Inc. (consulting), Vericel Corp. (consulting), Linvatec Corp. (speaking fee), DePuy Synthes Inc. (consulting) RHB: Arthrex Inc (speaking fees/services other than consulting, hospitality payments, education); Sanofi (consulting fees, hospitality payments); Elite Orthopedics (education); Smith & Nephew (education); BREGG (education) MJM:Arthrex Inc (Educational activities/travel and lodging); Elite Orthopedics/Apollo Orthopedics (Educational activity); Pacira Pharmaceuticals (Consulting); Heron Therapeutics (Consulting) MVS: Elite Orthopedics (Speaker); Arthrex; Flexion Therapeutics (Consultant)