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Proximal tibiofibular dislocations likely indicators of severely traumatized limbs
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Traumatic tibiofibular joint dislocations were seen in 1% to 2% of tibial plateau and tibial shaft fractures and, based on recently published data, they are indicators of severely traumatized limbs.
Researchers included 30 skeletally mature patients who were surgically treated for proximal tibiofibular dislocations (PTFD) in their study. They analyzed the patients’ charts for age, sex, injury mechanism, injury pattern, Orthopaedic Trauma Association (OTA) classification, open fracture grade, compartment syndrome, vascular injury, neurologic injury and recovery. Researchers used the Fisher exact test for the statistical analysis.
The results showed 30 patients had 30 PTFDs among 1,013 operative tibial shaft fractures and 803 operative tibial plateau fractures. The incidence of PTFD in tibial shaft fractures and tibial plateau fractures was calculated at 1.5% and 1.9%, respectively. Of the plateau fractures that correlated with PTFD, 60% were open injuries whereas 93% of shaft fractures correlated with PTFD and were open injuries.
The difference between the OTA C-type and OTA B-type incidence was statistically significant for both shaft and plateau fractures. Plateau fractures correlated with PTFD, however the difference was not significant for them between OTA C-type and OTA A-type. Two patients developed vascular injury and successfully underwent repair with no vascular sequelae and two other patients required amputation for a nonreconstructable extremity.
In 28 patients, there was a 29% incidence of compartment syndrome and a 36% incidence of peroneal nerve palsy. In all, 30% of patients with peroneal nerve palsy clinically recovered at an average follow-up of 11 months, according to the study. ‒ by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.
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