Surgical stabilisation of the proximal tibiofibular joint using temporary fixation A technical note


Published online: Dec 27 2004

Michel P. J. VAN DEN BEKEROM, Adam WEIR, Rudolf E. VAN DER FLIER

From the Medical Centre Haaglanden, Antoniushove Hospital, Leidschendam, The Netherlands

Abstract

Proximal tibiofibular instability is a symptomatic hypermobility of this joint possibly associated with subluxation. It is a rare condition both in clinical practice and in literature. The treatment of choice for proximal tibiofibular instability remains conservative, using a brace 1 cm underneath the head of the fibula. If no improvement is noted after six months of conservative treatment, surgical intervention can be considered : there are several options, such as resection of the head of the fibula, permanent arthrodesis of the proximal tibiofibular joint, reconstruction using either the tendon of the biceps femoris or a portion of the iliotibial tract, or temporary (three to six months) fixation using a screw together with release of the peroneal nerve.