Split biceps femoris tendon reconstruction for proximal tibiofibular joint instability.

Recurrent instability of the proximal tibiofibular joint is an infrequently diagnosed abnormality. We present a new technique for reconstructing the joint using a split biceps femoris tendon passed through a bone tunnel in both the proximal tibial metaphysis and fibular head. The case report is also presented. The procedure offers an anatomic reconstruction and firm stabilization. It allows normal motion of the proximal tibiofibular joint and preserves the normal mechanics of the ankle. This procedure is an excellent alternative to resection of the fibular head, transarticular arthrodesis, or pseudoarthrosis focus at the fibular head.

The epidemiology of knee dislocations.

The traumatically dislocated knee can be a devastating injury; fortunately, it is uncommon. More attention is being given to the treatment of knee dislocations as the capability of ligamentous reconstruction increases. Great treatment advances are anticipated as this interest grows and outcomes are evaluated. Nonetheless, the complications of this injury, including loss of limb, still occur from the missed diagnosis of a knee dislocation. MR imaging and other technological advances do not relieve the clinician of the responsibility for performing a thorough physical examination. Suspicion of an associated neurovascular injury must always be high. To a certain degree, prevention of this injury may be possible in the high-velocity accidents that occur with motor vehicles and in industry. Advancement in vehicular designs, with specific attention to airbags, dashboards, and firewalls, needs to be made to reduce the incidence and magnitude of lower extremity trauma in motor vehicle accidents. Seat belts remain the most effective restraint in the prevention of lower extremity trauma in the motor vehicle.