Tibia and Fibula Subluxation

(From the June 2007 The “G”Note)

Editor: Extremity injuries occur frequently as most of us know in our personal lives and most of these patients benefit from chiropractic care. Early intervention can often save someone from a lifetime of chronic pain and/or joint instability or even significant disability. In the Gonstead protocol, when faced with a injury of an extremity, always check the spine. Occasionally, there are no spinal subluxations, only an extremity injury. This is a case of a knee injury as a result of a misstep.

March 28, 2007
A 52-year-old male presented to our office with acute knee pain of three weeks duration. He stated that he had stepped into a hole and “twisted” his knee.

Upon examination, the knee had minimal swelling. Palpation revealed pain on the medial and lateral aspects of the tibia and the lateral aspect of the proximal fibula. ROM was restricted and elicited pain. AP x-ray of the knee revealed listing of an AEx tibia and a PM fibula.

The fibula was adjusted on the Hy-Lo table with the patient prone. The tibial was adjusted with the patient seated on the cervical chair. The patient was instructed to use a cold pack on the knee for 20 minutes following the adjustments.

April 4, 2007
The patient stated that he feels much better. ROM of the knee was improved with less pain elicited. The same adjustment procedures were done on the fibula and tibia.

April 11, 2007
The patient stated that he has no knee pain. Knee ROM of normal and without pain. Post-x-ray revealed improved tibia and fibular alignment. No adjustments were given, and the patient was released.

Recommendations to the patient:
1. Walk 15-20 minutes daily on level surfaces, “grass” preferably.
2. Pedal a stationary bike 10 minutes daily – 5 minutes forward and 5 minutes backwards. This exercise is to strengthen the muscles around the knee.

NOTE: Dr. Vance stated that he was also adjusting L5.

There is significant misalignment of the tibia and femur lines. The proximal fibular is nearly hidden behind the tibia when compared to the right side which shows a space between the proximal tibia and fibula.

AP x-rays 4/11/07 There is improvement of the alignment of the tibia and femur lines. A space now appears between the proximal tibia and fibula.