Proximal tibiofibular joint dislocation is an uncommon injury to a joint at the outer knee where the adjoining tibia and fibula bones are displaced from their normal position and the joint surfaces no longer touch each other.
This joint is separate from the knee joint and involves the tibia and fibula (two bones of the lower leg). These bones also form the upper part of the ankle joint. Proximal tibiofibular joint dislocations can occur in isolation or along with other acute injuries, tibiofibular fractures, or ankle fractures.
What Is Proximal Tibiofibular Joint Dislocation?
A proximal tibiofibular joint dislocation occurs when the head of the fibula separates from the tibia, tearing the tibiofibular ligaments that help hold the joint in place.
The injury can result from a direct blow to a bent knee, a twisting injury, or a fall in the “hurdler’s” position. It may also occur in association with ankle injuries or without a specific injury in people with loose joints.
Dislocation causes the joint surfaces to lose their normal alignment and may require repositioning of the bones to restore the joint.
Causes and Risk Factors
Causes of proximal tibiofibular joint dislocation include:
- A direct blow to a bent knee or a twisting injury
- Falling in the “hurdler’s” position
- Ankle fracture-dislocation
- Infection, growth disturbances, or congenital conditions
- Joint looseness that allows dislocation without a specific injury
Risk factors include:
- Sports involving falls or sliding, such as baseball, soccer, wrestling, and football
- Activities such as skiing, gymnastics, basketball, horseback riding, rugby, and judo
- Congenitally loose ligaments (“double-jointed”)
- Direct trauma to the knee
Using proper technique when falling, landing, or sliding in sports and avoiding irregular playing surfaces may help prevent injury.
Symptoms
Frequent signs and symptoms of proximal tibiofibular joint dislocation include:
- Pain along the outer knee and occasionally in the ankle
- Pain that may be severe when standing or moving the affected leg or knee, or may feel like an ache
- Giving way or buckling of the knee
- Locking or catching of the knee
- An obvious bump on the outer side of the knee, often accompanied by tenderness, mild swelling, or bruising
- Increased knee pain with ankle movement
- Numbness or paralysis below the dislocation due to stretching of nearby nerves (uncommon)
Treatment
Treatment begins with reduction (repositioning of the bones of the joint) by trained medical personnel to restore the joint to its normal position.
Although reduction can sometimes be performed without surgery, surgical treatment may be necessary to repair torn ligaments and hold the joint in place, particularly when the dislocation cannot be reduced or recurrent dislocations occur.
Following reduction, treatment may include:
- Immobilization: Splinting, casting, or bracing for 2 to 8 weeks to protect the joint while the ligaments heal.
- Pain and Swelling Management: Ice, prescribed or recommended medications, and elevating the injured foot and ankle at or above heart level to help reduce swelling.
- Rehabilitation: Stretching and strengthening exercises after immobilization or surgery to restore strength and function. These exercises may be performed with or without the assistance of a physical therapist or athletic trainer.
Nonsteroidal anti-inflammatory medications, such as aspirin and ibuprofen, or other pain relievers, such as acetaminophen, may be recommended as directed by a physician.
Cold therapy may help relieve pain and reduce inflammation, while heat may be used before prescribed stretching and strengthening exercises.
Recovery and Outcomes
Reduction (repositioning of the joint) often requires surgery and a prolonged recovery. Full recovery may take up to 4 to 6 months, depending on the injury and treatment required.
After immobilization or surgery, stretching and strengthening exercises are important for the injured joint and surrounding muscles. Resuming activity too soon may lead to prolonged healing or recurrent dislocation.
Potential complications include:
- Damage to nearby nerves caused by stretching during the dislocation
- Associated fractures or joint cartilage injuries
- Prolonged healing or recurrent dislocation
- Arthritis following repeated injury or delayed treatment
- Ankle pain
When to See Dr. Chudik
If you experience outer knee pain, swelling, an obvious bump near the knee, instability, or other symptoms associated with a proximal tibiofibular joint dislocation, contact Dr. Chudik’s office for an evaluation. Suspected dislocations require prompt medical assessment and repositioning by trained medical personnel.
Call 630-324-0402, email contactus@chudikmd.com, or schedule an appointment online.