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Fibula

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Description

Illustration of the fibula[1]

General

  • Is the smaller of the two bones of the leg.
  • Involvement in the transmission of weight is controversial
    • Some authors state not directly involved in the transmission of weight.
    • Others report it supports 7-16% of body weight during walking[2]
  • Is important for ankle stability.
  • Acts as a site for numerous muscle attachments.
  • Consists of a head, shaft and distal malleolus.

Anatomic Description

  • Head of fibula
    • Irregular with a small tubercle called the styloid process.
    • Articulates with the tibia to form the superior tibiofibular joint via an articular surface.
  • Fibular Neck
    • Common peroneal nerve wraps around, posterolaterally to anteromedially, before dividing into superficial and deep branches
  • Fibular Shaft
    • Three borders and three surfaces.
    • Anterior border: runs from the anterior aspect of the head to the triangular shaft proximal to the lateral malleolus.
    • Posterior border runs from the styloid process to the medial aspect of the posterior groove of the lateral malleolus.
    • Medial border is medial to the anterior border.
  • Distal Fibula
    • The Lateral malleolus has a triangular facet that articulates with the talus.

Pediatric Considerations

  • Sixty percent of growth comes from the proximal epiphysis[3]
    • This remains open for 18-20 years in males, 16-18 years in females

Actions

Articular

  • Static and dynamic knee stability
  • Proximal tibiofibular joint (PTFJ)
    • Communicates with the synovial joint space of the knee in 10% of people[4]
    • Stabilized by anterior and posterior proximal tibiofibular ligaments, fibular attachment of the LCL, interosseous membrane and distal tibiofemoral joint (DTFJ), surrounding musculature
    • Actions: buttress for tibial bending, dissipation of torsional forces applied to the ankle, tensile weight bearing[5]
  • Talocrural joint distally.

Muscle Attachments

Ligamentous

  • Lateral Collateral Ligament
  • Arcuate Complex
  • Interosseous membrane
  • Fibular collateral ligament of the knee joint
  • Anterior and posterior proximal tibiofibular ligaments
  • Anterior and posterior talofibular ligaments.

Vascular supply

  • Branches of the fibular artery.
  • Arterial anastomoses at the knee and ankle.

Innervation

  • Common fibular nerve branches.

Clinical Significance


See Also


References

  1. Image courtesy of teachmeanatomy.info, "The Fibula"
  2. Boulton, C., and R. O’Toole. "Tibia and fibula shaft fractures." Court-Brown C, Heckman J, McQueen M, Ricci W, Tornetta P III, editors. Rockwod and Greens Fractures in Adults 2 (2015): 2415-72.
  3. Rathjen, Karl E., and Harry KW Kim. "Physeal injuries and growth disturbances." Rockwood, Green, and Wilkins Fractures in Adults and Children: Eighth Edition. Wolters Kluwer Health Adis (ESP), 2014.
  4. de Almeida Silvares, Paulo Roberto, et al. "Acute isolated anterolateral dislocation of the proximal tibiofibular joint." Revista Brasileira de Ortopedia (English Edition) 45.4 (2010): 460-464.
  5. Alves-da-Silva, Teresa, et al. "Kinematics of the proximal tibiofibular joint is influenced by ligament integrity, knee and ankle mobility: an exploratory cadaver study." Knee Surgery, Sports Traumatology, Arthroscopy 27 (2019): 405-411.
Created by:
Alaa Khader on 28 June 2022 10:03:53
Authors:
Last edited:
31 July 2023 16:28:42
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