Een zeldzame oorzaak van laterale knieklachten: Proximale tibiofibulaire instabiliteit. Een case report en overzicht van de literatuur

By proximal tibiofibular instability we mean the symptomatic hyper-mobility associated with sub(luxation). It is a rare disorder, in the clinic as well as in literature. On the basis of a case study of a patient with proximal tibiofibular joint instability we first study the etiology, and pathology, then the diagnosis and lastly, the treatment of this disorder. Ogden describes four types of instability of the proximal tibiofibular joint: atraumatical subluxation, anterolateral, posteromedial and the rare superior or proximal luxation. Patients with a subluxation of the proximal tibiofibular joint specifically complain about lateral knee pain, which strongly increases when the fibulahead undergoes pressure. During clinical examination one can generate the instability. Radiology can be useful in making the diagnosis. The preferential treatment of this disorder remains conservative, using a brace band one cm. below the fibula head. If after six months this treatment has shown no success, surgical treatment can be considered. In our hospital we fixate the fibula head with a nail against the tibia along with a release of the peroneus nerve.