Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Orthop Sports Phys Ther. 2009 Nov;39(11):826. doi: 10.2519/jospt.2009.0414.
The patient was a 19-year-old female who reported an acute onset of lateral left knee pain while participating in a 3-legged race. The patient reported to the emergency department immediately following the injury. Observation revealed prominence along the lateral aspect of the knee. The patient was unable to bear weight on her left lower extremity and her symptoms were exacerbated with extension of the knee. Although the initial radiographs of the left knee and lower leg showed no apparent fracture, a widening of the interosseous space between the tibia and the fibula and an altered position of the fibular head were noted on the anterior to posterior radiographic view. On the lateral radiographic view there was anterior displacement of the left fibula compared to the right. These radiographic findings suggested an anterolateral dislocation of the fibular head, the diagnosis of which was confirmed upon the completion of axial computed tomography. Successful closed reduction was achieved and the patient was treated with a period of protected weight bearing on crutches, progressing to full weight bearing over 6 weeks. At 1 year following the injury, the patient was participating in all regular activities of daily living without pain or instability. Early detection and immediate reduction of an acute dislocation of the proximal tibiofibular joint are important to prevent long-term disability.
患者为 19 岁女性，在参加三足赛跑时突发左膝外侧疼痛。患者受伤后立即到急诊就诊。检查发现膝关节外侧突出。患者无法负重于左下肢，且膝关节伸展时症状加重。虽然左膝和小腿的初始 X 线片未见明显骨折，但前后位 X 线片显示胫骨和腓骨之间的骨间间隙增宽，腓骨头位置改变。外侧位 X 线片显示左侧腓骨相对于右侧向前移位。这些影像学表现提示腓骨头前外侧脱位，轴位 CT 检查后确诊。成功进行了闭合复位，患者用拐杖保护负重 6 周，然后逐渐完全负重。受伤 1 年后，患者无疼痛和不稳定，可参加所有日常活动。早期发现和立即复位急性胫腓骨近端关节脱位对于预防长期残疾很重要。
