An unusual rotational injury: Pantibial ligamentous injury.
Pantibial ligamentous injury including knee dislocation and tibiotalar joint subluxation is an uncommon severe rotational injury. A 21-year-old male injured his right knee falling from a motorcycle. Physical examination revealed effusion on the right knee and ankle, and posterior translation of the tibia as well. The MRI of the right knee and ankle demonstrated the following findings: a complete disruption of cruciate ligaments, the medial collateral ligament, posteromedial corner injury together with a peripheric tear in the medial meniscus, the ruptured deltoid ligament, ankle syndesmosis space widening (>5 mm) and lateral subluxation of talus. Deltoid ligament of the right ankle was repaired and ankle syndesmosis was fixed with a cortical screw. The PCL and ACL were reconstructed arthroscopically with autogeneous bone-patellar tendon-bone graft. The midsubstance tear of MCL, posteromedial corner and medial meniscus tear were primarily repaired with nonabsorbable sutures. 3 years after the surgery, the patient was called for the final examination. MRI and X-ray findings of the knee and ankle joint demonstrated the continuity of ACL, PCL, MCL, and deltoid ligament. The patient, who is a farmer, can go back to his job and perform his daily activities. We presented a previously unreported case that involves both simultaneous occurrence of knee dislocation and tibiotalar joint subluxation. We used the term "Pantibial ligamentous injury" for this case.
Yercan
Huseyin S
HS
Department of Orthopaedics and Traumatology, Celal Bayar University, Faculty of Medicine, Manisa, Turkey. yercanhes@yahoo.com
Okcu
Guvenir
G
Erkan
Serkan
S
Ozic
Ugur
U
D000058:Accidental Falls; D000328:Adult; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008023:Ligaments, Articular / Q000293:injuries* / Q000601:surgery; D008297:Male; D013977:Tibia