The forgotten joint: quantifying the anatomy of the proximal tibiofibular joint. PMID: 28321475. Arthroscopy. The first step in the management of chronic instability of the PTFJ is usually . Accessibility Instability of the proximal tibiofibular joint occurs when the ligaments which provide stability to this joint are injured. In the setting of acute injury and subsequent stabilization, the posterior PTFJ ligaments have been shown to scar, thereby precluding the need for a full reconstruction.22 Moreover, the avulsion fracture portends bone-to-bone healing and any reconstruction technique requiring drilling through the posteromedial aspect of the fibular head risks comminuting and further displacing the fracture fragment. The arthrodesis procedure is recommended for patients in whom the correction of joint instability would not relieve pain, such as patients with proximal tibiofibular joint arthritis. Proximal Tibiofibular Taping Example The proximal tibiofibular joint (PTFJ) is the articulation of the lateral tibial plateau of the tibia and the head of the fibula. The proximal tibiofibular joint should be palpated for tenderness, and laxity should be evaluated by translating the fibular head anteriorly and posteriorly with the thumb and index finger and asking the patient if the symptoms are reproduced or if there is any apprehension. Purpose: It is common for patients to also have transient peroneal nerve injuries, especially with posteromedial dislocation.1,2. Protection of the peroneal nerve during surgery helps to prevent injury and relieves symptoms common to this injury. Plain radiographs should be taken from anteroposterior, lateral, and oblique (45 to 60 degrees internal rotation of the knee) views, with comparison views from the contralateral knee, or from the preinjury knee if possible.5 When a diagnosis is suspected but not clearly established by plain radiographs, axial computed tomography has been found to be the most accurate imaging modality for detection of injury of the proximal tibiofibular joint.6 Magnetic resonance imaging (MRI) can also confirm a diagnosis of recent dislocation, based on the presence of pericapsular edema of the joint and edema of the soleus at its fibular origin of the popliteus muscle, but this finding is often absent in chronic and atraumatic cases.7 PDF Proximal Tibiofibular Joint (PTFJ): Stabilizing Tape Technique for The early recognition of instability in the proximal tibiofibular joint is necessary to optimize management of the injury and to avoid potential misdiagnosis. The tibiofibular joints are a set of articulations that unite the tibia and fibula. Proximal Tibiofibular Joint Instability and Treatment Approaches: A Dislocation of the proximal tibiofibular joint is a very uncommon condition that is easily misdiagnosed without clinical suspicion of the injury. PMID: 28326444. Atraumatic instability is more common and often misdiagnosed. In this regard, it is recommended that the strengths of grafts chosen for proximal tibiofibular reconstructions meet or exceed these values.
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