Art. 1.1475/ringraziamenti

Abstract. -We describe a case of isolated proximal tibiofibular joint dislocation in a 20 years old girl following trauma. Dislocation was reduced through a new and simple reduction technique after failure of classic reduction maneuver. This technique by using isokinetic movements lead to relax the fibular collateral ligament and allow the biceps tendon to snap the proximal end of the fibula back into the anatomical position. This technique propose simple maneuver to reduce isolated proximal tibiofibular joint dislocation. Key Words: Isolated proximal tibiofibular joint dislocation. Introduction Isolated proximal tibiofibular joint dislocation (PTFD) is associated with a severe twisting, inversion and plantar flexion of the foot, simultaneously with knee flexion and external rotation of the leg 1,2 ; it may also occur following direct high energy trauma to the knee 1,3,4 . Dislocation of the proximal end of the fibula is not always an isolated injury, as it is usually described. According to the literature, it may be associated with tibial fractures, femoral-shaft or head fracture, dislocation of the knee, fibular fracture and anterior fracture-dislocation of the distal femoral epiphysis. The patient usually present with pain along the lateral side of the knee and leg. This could be elicited by direct pressure over the fibular head (pushing it either forward or medially). Antero-posterior radiographs of the knee usually show the proximal fibula and tibia overlain 5 . In the majority of the cases, comparison between anterior and lateral radiographs on the two knees helps to confirm the diagnosis of fibular head dislocation Classification Understanding the mechanism of dislocation and classifying it, are critical for diagnosis, manage- . Type III -Posteromedial; this occurs in 10% of the cases and is frequently associated with direct trauma to the fibular head Most of these anterolateral dislocations occurred during athletic activity (especially violent, twisting motion). Several were associated with other skeletal injury: type-IV fracture-dislocation of the hip, crush injury of the proximal and distal ends of the tibia, fracture-dislocation of the ankle, proximal tibial fracture and fracture-dislocation of the distal femoral epiphysis. Case Report Here we report a case of 20 years old girl, arrived to our attention for right knee pain following the breaking of the heel tip of her high heel shoes. The mechanism of trauma was inversion and plantar flexion of the foot with simultaneous knee flexion and external rotation of the leg. She presented a 2014; 18(Suppl 1): [93][94][95