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Proximal Tibiofibular Joint and Proximal Fibula Fracture
Andrew Sonin, MD, FACR; Kirkland W. Davis, MD, FACR
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KEY FACTS

  • Imaging

    • Pathology

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Proximal tibiofibular joint (PTFJ)
          • Synonyms

            • Proximal syndesmosis injury of leg
          • Definitions

            • Injury to proximal tibiofibular articulation including dislocation, fracture, or ligament disruption

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    PATHOLOGY

                    • Staging, Grading, & Classification

                      • Gross Pathologic & Surgical Features

                        CLINICAL ISSUES

                        • Presentation

                          • Natural History & Prognosis

                            • Treatment

                              DIAGNOSTIC CHECKLIST

                              • Consider

                                • Image Interpretation Pearls

                                  Selected References

                                  1. Devitt BM et al: Physical examination and imaging of the lateral collateral ligament and posterolateral corner of the knee. Sports Med Arthrosc. 23(1):10-6, 2015
                                  2. Merrow AC et al: Avulsion fractures of the pediatric knee. Pediatr Radiol. 44(11):1436-45; quiz 1433-6, 2014
                                  3. Milankov M et al: Dislocation of the proximal tibiofibular joint. Med Pregl. 66(9-10):387-91, 2013
                                  4. Park S et al: Compartment syndrome in tibial fractures. J Orthop Trauma. 23(7):514-8, 2009
                                  5. Dirim B et al: Communication between the proximal tibiofibular joint and knee via the subpopliteal recess: MR arthrography with histologic correlation and stratigraphic dissection. AJR Am J Roentgenol. 191(2):W44-51, 2008
                                  6. Stuermer EK et al: Tibial shaft fracture and ankle joint injury. J Orthop Trauma. 22(2):107-12, 2008
                                  7. Al-Kashmiri A et al: Case report: Fatigue fracture of the proximal fibula with secondary common peroneal nerve injury. Clin Orthop Relat Res. 463:225-8, 2007
                                  8. Nikolaides AP et al: Inferior dislocation of the proximal tibiofibular joint: a new type of dislocation with poor prognosis. Arch Orthop Trauma Surg. 127(10):933-6, 2007
                                  9. Bozkurt M et al: The impact of proximal fibula fractures in the prognosis of tibial plateau fractures: a novel classification. Knee Surg Sports Traumatol Arthrosc. 13(4):323-8, 2005
                                  10. Lee J et al: Arcuate sign of posterolateral knee injuries: anatomic, radiographic, and MR imaging data related to patterns of injury. Skeletal Radiol. 32(11):619-27, 2003
                                  11. Sekiya JK et al: Instability of the proximal tibiofibular joint. J Am Acad Orthop Surg. 11(2):120-8, 2003
                                  12. Aladin A et al: The importance of early diagnosis in the management of proximal tibiofibular dislocation: a 9- and 5-year follow-up of a bilateral case. Knee. 9(3):233-6, 2002
                                  13. Juhng SK et al: MR evaluation of the "arcuate" sign of posterolateral knee instability. AJR Am J Roentgenol. 178(3):583-8, 2002
                                  14. Roy N et al: Superior dislocation of the superior tibiofibular joint associated with fracture of the tibial shaft. Injury. 29(6):486-8, 1998
                                  15. Morris JR et al: Magnetic resonance imaging of acute Maisonneuve fractures. Foot Ankle Int. 17(5):259-63, 1996
                                  16. Semonian RH et al: Proximal tibiofibular subluxation relationship to lateral knee pain: a review of proximal tibiofibular joint pathologies. J Orthop Sports Phys Ther. 21(5):248-57, 1995
                                  17. Harvey GP et al: Anterolateral dislocation of the proximal tibiofibular joint: case report and literature review. Todays OR Nurse. 14(3):23-7, 1992
                                  18. Veth RP et al: The abnormal proximal tibiofibular joint. Arch Orthop Trauma Surg. 102(3):167-71, 1984
                                  19. Veth RP et al: Traumatic instability of the proximal tibiofibular joint. Injury. 13(2):159-64, 1981
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Imaging

                                    • Pathology

                                      • Clinical Issues

                                        • Diagnostic Checklist

                                          TERMINOLOGY

                                          • Abbreviations

                                            • Proximal tibiofibular joint (PTFJ)
                                          • Synonyms

                                            • Proximal syndesmosis injury of leg
                                          • Definitions

                                            • Injury to proximal tibiofibular articulation including dislocation, fracture, or ligament disruption

                                          IMAGING

                                          • General Features

                                            • Radiographic Findings

                                              • CT Findings

                                                • MR Findings

                                                  • Imaging Recommendations

                                                    PATHOLOGY

                                                    • Staging, Grading, & Classification

                                                      • Gross Pathologic & Surgical Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Natural History & Prognosis

                                                            • Treatment

                                                              DIAGNOSTIC CHECKLIST

                                                              • Consider

                                                                • Image Interpretation Pearls

                                                                  Selected References

                                                                  1. Devitt BM et al: Physical examination and imaging of the lateral collateral ligament and posterolateral corner of the knee. Sports Med Arthrosc. 23(1):10-6, 2015
                                                                  2. Merrow AC et al: Avulsion fractures of the pediatric knee. Pediatr Radiol. 44(11):1436-45; quiz 1433-6, 2014
                                                                  3. Milankov M et al: Dislocation of the proximal tibiofibular joint. Med Pregl. 66(9-10):387-91, 2013
                                                                  4. Park S et al: Compartment syndrome in tibial fractures. J Orthop Trauma. 23(7):514-8, 2009
                                                                  5. Dirim B et al: Communication between the proximal tibiofibular joint and knee via the subpopliteal recess: MR arthrography with histologic correlation and stratigraphic dissection. AJR Am J Roentgenol. 191(2):W44-51, 2008
                                                                  6. Stuermer EK et al: Tibial shaft fracture and ankle joint injury. J Orthop Trauma. 22(2):107-12, 2008
                                                                  7. Al-Kashmiri A et al: Case report: Fatigue fracture of the proximal fibula with secondary common peroneal nerve injury. Clin Orthop Relat Res. 463:225-8, 2007
                                                                  8. Nikolaides AP et al: Inferior dislocation of the proximal tibiofibular joint: a new type of dislocation with poor prognosis. Arch Orthop Trauma Surg. 127(10):933-6, 2007
                                                                  9. Bozkurt M et al: The impact of proximal fibula fractures in the prognosis of tibial plateau fractures: a novel classification. Knee Surg Sports Traumatol Arthrosc. 13(4):323-8, 2005
                                                                  10. Lee J et al: Arcuate sign of posterolateral knee injuries: anatomic, radiographic, and MR imaging data related to patterns of injury. Skeletal Radiol. 32(11):619-27, 2003
                                                                  11. Sekiya JK et al: Instability of the proximal tibiofibular joint. J Am Acad Orthop Surg. 11(2):120-8, 2003
                                                                  12. Aladin A et al: The importance of early diagnosis in the management of proximal tibiofibular dislocation: a 9- and 5-year follow-up of a bilateral case. Knee. 9(3):233-6, 2002
                                                                  13. Juhng SK et al: MR evaluation of the "arcuate" sign of posterolateral knee instability. AJR Am J Roentgenol. 178(3):583-8, 2002
                                                                  14. Roy N et al: Superior dislocation of the superior tibiofibular joint associated with fracture of the tibial shaft. Injury. 29(6):486-8, 1998
                                                                  15. Morris JR et al: Magnetic resonance imaging of acute Maisonneuve fractures. Foot Ankle Int. 17(5):259-63, 1996
                                                                  16. Semonian RH et al: Proximal tibiofibular subluxation relationship to lateral knee pain: a review of proximal tibiofibular joint pathologies. J Orthop Sports Phys Ther. 21(5):248-57, 1995
                                                                  17. Harvey GP et al: Anterolateral dislocation of the proximal tibiofibular joint: case report and literature review. Todays OR Nurse. 14(3):23-7, 1992
                                                                  18. Veth RP et al: The abnormal proximal tibiofibular joint. Arch Orthop Trauma Surg. 102(3):167-71, 1984
                                                                  19. Veth RP et al: Traumatic instability of the proximal tibiofibular joint. Injury. 13(2):159-64, 1981