Semonian R H, Denlinger P M, Duggan R J
HealthSouth Sports Medicine and Rehabilitation Center, San Diego, CA, USA.
J Orthop Sports Phys Ther. 1995 May;21(5):248-57. doi: 10.2519/jospt.1995.21.5.248.
Proximal tibiofibular subluxation is the symptomatic hypermobility of the proximal tibiofibular joint. Pain along the lateral aspect of the knee must be carefully evaluated as the anatomy and biomechanics of this region are very complex. Anatomical variants of the proximal tibiofibular joint may be key to understanding the pathomechanics and, thus, treatment of this joint. The "horizontal" proximal tibiofibular joint has a higher degree of mobility, while the "oblique" joint is relatively immobile to rotational forces on the fibula. Increased fibular external rotation will result in injury to the anterior capsule and ligaments of the proximal tibiofibular joint causing common complaints of "popping" and lateral knee pain. Treatment of proximal tibiofibular subluxation will involve modifications of a patient's activity level and training programs, utilization of a supportive strap, lower leg strengthening, and modifications in the lower kinetic chain biomechanics.
胫腓近端半脱位是胫腓近端关节的症状性活动过度。由于该区域的解剖结构和生物力学非常复杂，因此必须仔细评估膝关节外侧的疼痛。胫腓近端关节的解剖变异可能是理解该关节的病理力学以及治疗的关键。“水平”胫腓近端关节具有更高的活动度，而“斜行”关节对腓骨上的旋转力相对固定。腓骨外旋增加会导致胫腓近端关节的前囊和韧带损伤，引起常见的“弹响”和膝关节外侧疼痛。胫腓近端半脱位的治疗将包括调整患者的活动水平和训练计划、使用支撑带、加强小腿力量以及调整下肢动力链生物力学。
