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近端胫腓关节脱位合并膝关节多韧带损伤:一例报告

Proximal tibiofibular dislocation with multiligament-knee injury: a case report.

作者信息

Gaitan Vargas Daniel, Fajardo Cantillo Cristian Camilo, Pérez Gibson Oriana

机构信息

Clinica Medicentro Familiar IPS, Colombia.

出版信息

Trauma Case Rep. 2025 Jun 4;58:101210. doi: 10.1016/j.tcr.2025.101210. eCollection 2025 Aug.

Abstract

Proximal tibiofibular dislocations are extremely rare, accounting for less than 1 % of knee injuries. They can present in isolation as a result of athletic participation or in combination with bony or ligamentous injuries, frequently associated with tibial shaft or proximal tibial fractures caused by high-energy trauma, such as motor vehicle accidents. A cohort study with a sample of 129 knees reports a 9 % incidence of proximal tibiofibular instability in patients with multiligament-knee injurie. Multiligament-knee injuries are also uncommon, primarily resulting from high-energy trauma, posing a challenge for the surgeon, and requires a meticulous clinical evaluation and surgical planning to achieve satisfactory outcomes. This is a retrospective descriptive study based on the collection of clinical data from a patient who was a victim of a motor vehicle accident with proximal tibiofibular dislocation involving the posterior cruciate ligament and posterolateral corner, who underwent a single-stage surgical intervention to ensure early functional rehabilitation. The significance of this case lies in the fact that it represents the second reported case of a proximal tibiofibular dislocation with multiligament-knee injury without other associated injuries, in addition to being a recent case reported ten years after the last similar publication.

摘要

胫腓近侧关节脱位极为罕见,占膝关节损伤的比例不到1%。它们可因运动参与单独出现,或与骨或韧带损伤同时存在,常与高能创伤(如机动车事故)导致的胫骨干或胫骨近端骨折相关。一项对129个膝关节样本的队列研究报告称,多韧带膝关节损伤患者中胫腓近侧关节不稳定的发生率为9%。多韧带膝关节损伤也不常见,主要由高能创伤引起,给外科医生带来挑战,需要细致的临床评估和手术规划才能取得满意的结果。这是一项回顾性描述性研究,基于一名机动车事故受害者的临床数据收集,该患者患有胫腓近侧关节脱位并累及后交叉韧带和后外侧角,接受了一期手术干预以确保早期功能康复。该病例的意义在于,它是第二例报告的无其他相关损伤的胫腓近侧关节脱位合并多韧带膝关节损伤的病例,且是自上一次类似发表后的十年内报告的最新病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b92/12269565/1f921fc4046b/gr1.jpg

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