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Generalized ligament laxity associated with isolated proximal tibiofibular joint dislocation

  • Royce Ekkawit PaschkewitzEmail author
  • Buddhika Balalla
  • Peter John Papantoniou
  • Siew-Piau Tan
Case Report

Abstract

Proximal tibiofibular dislocations are a rare orthopaedic injury. It is one that is easily missed if one does not have high clinical suspicion for such an injury. This report discusses two cases of proximal tibiofibular dislocations that presented to the emergency department. In both cases, the patients fulfilled the criteria for having generalized ligamentous laxity—including passive apposition of thumb to extensor aspect of forearm, passive hyperextension of the fingers so that they lie parallel to the forearm, hyperextension of the elbow and knee, and excessive range of passive dorsiflexion of the ankle and eversion of the foot. Both cases also highlighted the difficulty in diagnosing the injury with single X-ray films, requiring additional comparison films to confirm the diagnosis.

Keywords

Generalized Ligamentous laxity Proximal tibio-fibular Dislocation Hypermobility syndrome 

Laxité ligamentaire associée à une luxation tibio-fibulaire

Résumé

Les luxations tibio-fibulaires proximales constituent un traumatisme rare. C’est pourquoi cette lésion est fréquemment négligée en l’absence de signes cliniques hautement évocateurs. Cet article rapporte deux cas de luxation tibio-fibulaire proximale vus dans notre service d’urgences. Dans les deux cas, les patients remplissaient tous les critères correspondant à une laxité ligamentaire généralisée, y compris la possibilité de faire se toucher passivement le pouce et le bord radial de l’avant-bras, l’hyperextension passive des doigts arrivant jusqu’à les rendre paralllèles avec l’avant-bras, l’hyperextension des genoux et des coudes ainsi qu’une excessive dorsi-flexion passive des chevilles et une éversion des pieds. Les deux cas soulignaient également la difficulté de poser le diagnostic de lésion traumatique avec des clichés radiographiques simples, des clichés comparatifs étant indispensables pour le confirmer. Bien que nous devons reconnaître qu’un traumatisme puisse à lui seul provoquer cette luxation, il apparaît néanmoins que l’hyperlaxité généralisée constitutionnelle constitue un terrain prédisposant.

Mots clés

Laxité ligamentaire constitutionnelle généralisée Luxation tibio-fibulaire proximale Hypermobilité 

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Royce Ekkawit Paschkewitz
    • 1
    • 2
    Email author
  • Buddhika Balalla
    • 1
  • Peter John Papantoniou
    • 1
  • Siew-Piau Tan
    • 1
  1. 1.Department of OrthopaedicsSutherland HospitalCaringbahAustralia
  2. 2.Department of OrthopaedicsSutherland HospitalSydneyAustralia

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