Moscon Antonio Carlos, Martimbianco Ana Luiza Cabrera, Duarte Junior Aires, Gracitelli Guilherme Conforto
Ortocity Serviços Médicos, Sao Paulo, Brazil.
Universidade Metodista de Santos (UNIMES), Santos, SP, Brazil.
BMJ Case Rep. 2018 Mar 30;2018:bcr-2017-222843. doi: 10.1136/bcr-2017-222843.
We present the case of a 40-year-old man who suffered an isolated proximal tibiofibular dislocation of the left knee after a trauma during a soccer game. Physical examination and radiographic imaging revealed an anterolateral dislocation of the proximal fibula. The diagnosis was confirmed by MRI. The treatment choice was open reduction and internal fixation under direct visualisation using flexible and permanent internal fixation. Postoperative treatment includes knee immobilisation during the first week, and partial weight was allowed for 2 weeks progressing to full weight bearing over 4 weeks. The patient started a gradual and progressive physical therapy programme with range of motion exercises, muscle strengthening and gait training. Full knee range of motion was achieved after 4 weeks. No complaint of pain or hardware discomfort was reported, and the patient is back to daily life and sports activities after 6 months of surgical treatment.
我们报告一例40岁男性病例，该患者在一场足球比赛中受伤后，出现了左膝单纯性近端胫腓关节脱位。体格检查和影像学检查显示腓骨近端前外侧脱位。MRI确诊了该诊断。治疗选择是在直视下进行切开复位内固定，采用柔性和永久性内固定。术后治疗包括第一周膝关节制动，2周内允许部分负重，4周内逐渐过渡到完全负重。患者开始了一个渐进性的物理治疗计划，包括关节活动度练习、肌肉强化和步态训练。4周后实现了膝关节的全范围活动。未报告疼痛或内固定不适的主诉，手术治疗6个月后患者恢复了日常生活和体育活动。
