Generalized ligament laxity associated with isolated proximal tibiofibular joint dislocation

Proximal tibiofibular dislocations are a rare orthopaedic injury. It is one that is easily missed if one does not have high clinical suspicion for such an injury. This report discusses two cases of proximal tibiofibular dislocations that presented to the emergency department. In both cases, the patients fulfilled the criteria for having generalized ligamentous laxity—including passive apposition of thumb to extensor aspect of forearm, passive hyperextension of the fingers so that they lie parallel to the forearm, hyperextension of the elbow and knee, and excessive range of passive dorsiflexion of the ankle and eversion of the foot. Both cases also highlighted the difficulty in diagnosing the injury with single X-ray films, requiring additional comparison films to confirm the diagnosis.