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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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