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ResumoUma fratura osteocondral desviada da tíbia anterolateral associada a avulsão da cabeça da fíbula em um paciente de 50 anos é relatada. A fratura avulsão do trato iliotibial em geral está associada lesões do ligamento cruzado, do menisco, e das estruturas laterais do joelho, como no caso em questão.

Snapping biceps femoris tendon (BFT) over the fibular head is an uncommon cause of lateral knee pain. This study reports a case of nontraumatic painful snapping of the BFT due to a prominent fibular head that was persistent intraoperatively after fibular head resection. We describe a novel surgical technique of release of the anterior arm of the biceps tendon followed by soft tissue tenodesis to the popliteofibular ligament, as opposed to the remaining fibular head, to prevent iatrogenic fracture.

Reconstruction of the posterolateral corner of the knee using two-tailed techniques involved grafts originating from the femur and inserting on the proximal tibia and fibular head. This method reconstructs the fibular collateral ligament, popliteofibular ligament, and popliteus tendon using anatomically placed grafts. This article describes the history, anatomy, indications, and authors' preferred technique for a two-tailed posterolateral corner reconstruction. In addition, biomechanical and clinical outcomes of this technique will be compared.

The purpose of this article is to present the author's experience with fibular head-based surgical procedures for the treatment of posterolateral instability of the knee. The surgical techniques presented are the biceps tendon transfer procedures and the fibular head-based figure of eight posterolateral reconstruction using free grafts. Each of these techniques is combined with capsular repair and/or posterolateral capsular shift procedures in all cases. The decision points for surgical technique selection, the surgical technique itself, the postoperative rehabilitation, and the outcomes of these surgical procedures are presented, including a comparison of the biceps tendon procedures with the free graft procedure.

Originally described in the 1970s, vascularized bone grafting has become a critical component in the treatment of bony defects and non-unions. Although well established in the lower extremity, recent years have seen many novel techniques described to treat a variety of challenging upper extremity pathologies. Here the authors review the use of different techniques of vascularized bone grafts for the upper extremity bone pathologies. The vascularized fibula remains the gold standard for the treatment of large bone defects of the humerus and forearm, while also playing a role in carpal reconstruction; however, two other important options for larger defects include the vascularized scapula graft and the Capanna technique. Smaller upper extremity bone defects and non-unions can be treated with the medial femoral condyle (MFC) free flap or a vascularized rib transfer. In carpal non-unions, both pedicled distal radius flaps and free MFC flaps are viable options. Finally, in skeletally immature patients, vascularized fibular head epiphyseal transfer can provide growth potential in addition to skeletal reconstruction.

The isolated dislocation of the fibula head is a rare injury which therefore often represents a diagnostic and therapeutic problem. With the case report and literature review we want to bring this injury into the forefront and illustrate the conservative and operative treatment possibilities.