PMC6949672_01
Anteroposterior and lateral radiographs showing the healed proximal tibia fracture and posterior subluxation of the tibia. Weight-bearing AP (a) and lateral (b) radiographs of MR AD showing evidence of a healed proximal tibia and fibula fracture and posterior subluxation of the tibia on the femur. Importantly, the posterior slope of his proximal tibia is within normal limits measuring 6 degrees.
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His X-rays confirmed a healed proximal tibia and fibula fracture as well as posterior subluxation of his tibia on his femur (Figure 1).
Clinical photographs with the gastrocnemius relaxed (a) and contracted (b). Note that the photograph is taken in the seated position to better illustrate the position of the foot. In (a), the ankle is dorsiflexed to illustrate calf relaxation, whereas in (b), the ankle is plantarflexed to illustrate gastrocnemius contraction. Patient with a positive "quads active test" who does not activate his quads to reduce his tibiofemoral articulation. Note that in (a), his gastrocnemius is relaxed (hence his dorsiflexed ankle) and his tibia is posteriorly subluxed, but in (b), his gastrocnemius is contracted and the tibiofemoral articulation is reduced. These findings were consistent when lying supine or sitting erect (as above).
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