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Abstract
Anteromedial force to the knee in an extended position can cause an avulsion fracture of the proximal fibula with combined injuries to the posterolateral ligaments. Avulsion fractures of the proximal fibula are rare and current management of these fractures is based on few descriptions in literature. Various surgical methods of fixation for these fractures have been reported, but there is still no standard treatment modality. Anatomic reduction of these fractures is technically difficult, and failure of reduction may cause posterolateral instability, secondary arthritis and other complications. We present our experience with two such cases of comminuted avulsion fractures of the proximal fibular with posterolateral ligament ruptures surgically fixated with a locking compression hook plate and non absorbable sutures.
Figures and Tables
Fig. 1
Left knee antero-posterior and lateral view show a comminuted avulsion fracture of the fibular head.
Fig. 4
Intraoperative photograph shows the avulsion fracture of the fibular head and lateral collateral ligament injury. The blue: comminuted avulsion fracture of the proximal fibula. The red: avulsed and stretched lateral collateral ligament. The yellow: common peroneal nerve.
Fig. 5
The lateral collateral ligament was sutured using a non-absorbable suture with Baseball whipstitch technique. The blue: comminuted avulsion fracture of the proximal fibula. The red: avulsed and stretched lateral collateral ligament. The yellow: common peroneal nerve. The white: non absorbable suture (#5 ethibond).
References
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