High and Rapid Effectiveness of Manipulation in the Symptomatic Subluxation of the Proximal Tibiofibular Joint in a Child: A Case Report

*Corresponding author: Olena Plotkina* and Andrei Bourdeinyi

Abstract

In this article, a case of the lower leg and feet pain and cramps in a 5-year-old girl disturbing the child for two-years was described. These symptoms had been occurring just during the nights and lasted sometimes for 2-3-hours. There were no visible causes of this disorder. Previous examinations in a pediatric office and by a podiatrist did not reveal any pathology. In our office, both fibular heads were found to be subluxated postero-medially. We hypothesized that a causative factor of the pain and cramps was the involvement of the common peroneal nerve due to this subluxation. Manipulation of the fibular heads (a high-velocity, low-amplitude thrust) eliminated these symptoms after just two visits. In the future, these symptoms in the child occurred just a couple of times during the next eight-years of follow-up observations. Various types of treatment of the proximal tibiofibular joint pathology, the common peroneal nerve involvement, and the significance of manipulative therapy in this type of involvement that resulted in rapid and high effectiveness, are discussed in the article.
Keywords
Proximal tibiofibular joint (PTFJ); Symptomatic subluxation; Manipulative therapy; Joint dislocation; Postero-medial subluxation.