High and Rapid Effectiveness of Manipulation in the Symptomatic Subluxation of the Proximal Tibiofibular Joint in a Child: A Case Report
Keywords:
Proximal tibiofibular joint (PTFJ), Symptomatic subluxation, Manipulative therapy, Joint dislocation, Postero-medial subluxation.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.
