Anterolateral dislocation of the head of the fibula in sports

Abstract

Traumatic anterolateral dislocation of the fibular head is an uncommon sports injury which is easily overlooked. Seventeen cases have been collected during private practice over the years. The typical mechanism of injury is a fall on the affected flexed knee with the leg adducted under the body and the ankle inverted. On physical examination there is an obvious bony prominence laterally of the fibular head and varying disability with activities; there is no significant effusion or signs of internal knee derangement or instability. Comparison identical radiographic views are necessary to confirm the diagnosis: on the anteroposterior view the fibular head is displaced laterally and the proximal interosseous space is widened; on the lateral view there is a greater overlap of the fibula on the tibia on the affected side. Peroneal nerve and ankle injuries can occur concomitantly with anterolateral proximal tibiofibular dislocation. Treatment options are closed or open reduction acutely and local strapping or fibular head resection for chronic cases based upon time of presentation and disability.