Instability of the knee may be a sign of avulsion of the LCL, posterolateral corner injury or occult knee dislocation. In blunt trauma, thorough examination of the entire extremity is necessary as these injuries rarely occur in isolation.
Regardless of the mechanism, a detailed ligamentous knee exam and neurovascular exam of the lower extremity should be performed. This information may give clues to associated injury. History should attempt to ascertain the mechanism of injury. Diagnosisĭiagnosis of these injuries requires thorough history and physical exam. Often there will be an antalgic gait or inability to bear weight. There may be effusion or hemarthrosis if intra-articular structures of the knee are injured. There will generally be edema and tenderness to palpation directly over the proximal fibula, however, if there may not be obvious deformity of the leg if the tibia is intact. Presentation of these injuries is quite variable and will depend on the amount of energy imparted to the leg and the extent of associated fracture, ligamentous injury or neurovascular injury. ClassificationĬlassification of these fractures is descriptive and includes description of the location and dominant fracture pattern. This membrane is important in its relationship in transmitting rotational forces from the ankle to the proximal fibula in certain types of ankle injuries.
The interosseous membrane between the tibia and fibula runs the length of these bones and originates in the proximal tibia and fibula. Additionally, lateral collateral ligament of the knee originates from the lateral epicondlye of the femur to insert on the superior portion of the fibular head and is the major restraint to varus forces on the knee at zero and thirty degrees of flexion. The proximal fibula is the insertion point for the biceps femoris posterolaterally, the soleus posteriorly, and the peroneus longus and extensor digitorum longus anteiorly. The proximal fibula lies in close association with multiple significant ligamentous and neurovascular structures. Fractures of the proximal fibula rarely occur in isolation and their significance lies more with this fracture's association with injuries to the ligamentous and neurovascular structures than with the boney injury.
0 kommentar(er)
