{"title":"Fibular-Sided Avulsion of Posterior Inferior Tibiofibular Ligament-Patel-Sharma Fragment: A Case Report.","authors":"Sandeep Patel, Mandeep S Dhillon, Ankit Dadra, Ansh Gupta, Siddhartha Sharma","doi":"10.2106/JBJS.CC.24.00238","DOIUrl":null,"url":null,"abstract":"<p><strong>Case: </strong>A 30-year-old man presented with left proximal tibia fracture (open Grade 3A) and a transverse lateral malleolus fracture (Weber B) following direct impact injury. Computed tomography revealed a rare posteromedial tubercle fibula fracture at the posterior inferior tibiofibular ligament (PITFL) insertion, with syndesmosis disruption. Initial damage control included an external fixator. Definitive surgery, performed 10 days later, used Herbert screws and a tubular plate, along with syndesmotic screws.</p><p><strong>Conclusion: </strong>This case highlights a unique fracture pattern: PITFL avulsion from the fibular end which we wish to name as Patel-Sharma fragment. Identifying this fragment is essential as it needs to be fixed to ensure posterior syndesmosis ring stability.</p>","PeriodicalId":14748,"journal":{"name":"JBJS case connector","volume":"15 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JBJS case connector","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2106/JBJS.CC.24.00238","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Case: A 30-year-old man presented with left proximal tibia fracture (open Grade 3A) and a transverse lateral malleolus fracture (Weber B) following direct impact injury. Computed tomography revealed a rare posteromedial tubercle fibula fracture at the posterior inferior tibiofibular ligament (PITFL) insertion, with syndesmosis disruption. Initial damage control included an external fixator. Definitive surgery, performed 10 days later, used Herbert screws and a tubular plate, along with syndesmotic screws.
Conclusion: This case highlights a unique fracture pattern: PITFL avulsion from the fibular end which we wish to name as Patel-Sharma fragment. Identifying this fragment is essential as it needs to be fixed to ensure posterior syndesmosis ring stability.
期刊介绍：
JBJS Case Connector helps improve patient care by providing the medical community with a journal that harnesses technology to provide information tools for discovery and reporting of unusual musculoskeletal problems, findings, treatment, and outcomes. Co-edited by Thomas W. Bauer, MD, PhD, and Ronald W. Lindsey, MD, JBJS Case Connector assists orthopaedic surgeons in the search for precedents, connections, and trends in their efforts to improve patient care. Using this unique journal, surgeons can find the commonalities between cases, benefit from the experience of their peers, and filter case information by many important variables in order to provide the best possible care for orthopaedic patients. This cross-referenced online journal includes thousands of orthopaedic case reports. It compiles symptoms, conditions, and demographic details to empower surgeons to find cases similar to theirs. Surgeons can mine the database to reveal emerging trends and identify patterns, distinguishing between truly rare cases and repeated, related single instances of a larger problem. The JBJS Case Connector Image Quiz feature provides interactive quizzes based on images from content published by JBJS and includes a discussion area for further exploration of ideas and concepts. The JBJS Image Quiz app for iPad and iPhone is available in the App Store. Contributions to JBJS Case Connector are welcomed from anywhere in the world and are considered on their merits. Articles must be written in English and should be submitted as outlined in the Instructions to Authors. All authors must abide by the JBJS ethics policies and all submissions to JBJS Case Connector are covered by the JBJS embargo policy.
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