Fibula

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Fibula
Fibula - anterior view.png
Position of fibula in human body (shown in red)
Braus 1921 293.png
Cross section of human lower leg, showing fibula in centre (latin terminology)
Details
Pronunciation /ˈfɪbjʊlə/ [1] [2]
Articulations Superior and inferior tibiofibular joint
Ankle
Identifiers
Latin (os) fibula
MeSH D005360
TA98 A02.5.07.001
TA2 1427
FMA 24479
Anatomical terms of bone
3D medical animation still shot of fibula structure 3D Medical Animation Fibula Structure.jpg
3D medical animation still shot of fibula structure

The fibula (pl.: fibulae or fibulas) or calf bone is a leg bone on the lateral side of the tibia, to which it is connected above and below. It is the smaller of the two bones and, in proportion to its length, the most slender of all the long bones. Its upper extremity is small, placed toward the back of the head of the tibia, below the knee joint and excluded from the formation of this joint. Its lower extremity inclines a little forward, so as to be on a plane anterior to that of the upper end; it projects below the tibia and forms the lateral part of the ankle joint.

Contents

Structure

The bone has the following components:

Blood supply

The blood supply is important for planning free tissue transfer because the fibula is commonly used to reconstruct the mandible. The shaft is supplied in its middle third by a large nutrient vessel from the fibular artery. It is also perfused from its periosteum which receives many small branches from the fibular artery. The proximal head and the epiphysis are supplied by a branch of the anterior tibial artery. In harvesting the bone the middle third is always taken and the ends preserved (4 cm proximally and 6 cm distally)

Development

The fibula is ossified from three centers, one for the shaft, and one for either end. Ossification begins in the body about the eighth week of fetal life, and extends toward the extremities. At birth the ends are cartilaginous.

Ossification commences in the lower end in the second year, and in the upper about the fourth year. The lower epiphysis, the first to ossify, unites with the body about the twentieth year; the upper epiphysis joins about the twenty-fifth year.

The upper extremity or head of the fibula is of an irregular quadrate form, presenting above a flattened articular surface, directed upward, forward, and medialward, for articulation with a corresponding surface on the lateral condyle of the tibia. On the lateral side is a thick and rough prominence continued behind into a pointed eminence, the apex (styloid process ), which projects upward from the posterior part of the head.

The prominence, at its upper and lateral part, gives attachment to the tendon of the biceps femoris and to the fibular collateral ligament of the knee-joint, the ligament dividing the tendon into two parts.

The remaining part of the circumference of the head is rough, for the attachment of muscles and ligaments. It presents in front a tubercle for the origin of the upper and anterior fibers of the peroneus longus, and a surface for the attachment of the anterior ligament of the head; and behind, another tubercle, for the attachment of the posterior ligament of the head and the origin of the upper fibers of the soleus.

Body

The body of the fibula presents four borders - the antero-lateral, the antero-medial, the postero-lateral, and the postero-medial; and four surfaces - anterior, posterior, medial, and lateral.

Borders

The antero-lateral border begins above in front of the head, runs vertically downward to a little below the middle of the bone, and then curving somewhat lateralward, bifurcates so as to embrace a triangular subcutaneous surface immediately above the lateral malleolus. This border gives attachment to an intermuscular septum, which separates the extensor muscles on the anterior surface of the leg from the peronaei longus and brevis on the lateral surface.

The antero-medial border, or interosseous crest, is situated close to the medial side of the preceding, and runs nearly parallel with it in the upper third of its extent, but diverges from it in the lower two-thirds. It begins above just beneath the head of the bone (sometimes it is quite indistinct for about 2.5 cm. below the head), and ends at the apex of a rough triangular surface immediately above the articular facet of the lateral malleolus. It serves for the attachment of the interosseous membrane, which separates the extensor muscles in front from the flexor muscles behind.

The postero-lateral border is prominent; it begins above at the apex, and ends below in the posterior border of the lateral malleolus. It is directed lateralward above, backward in the middle of its course, backward, and a little medialward below, and gives attachment to an aponeurosis which separates the peronaei on the lateral surface from the flexor muscles on the posterior surface.

The postero-medial border, sometimes called the oblique line, begins above at the medial side of the head, and ends by becoming continuous with the interosseous crest at the lower fourth of the bone. It is well-marked and prominent at the upper and middle parts of the bone. It gives attachment to an aponeurosis which separates the tibialis posterior from the soleus and flexor hallucis longus.

Surfaces

The anterior surface is the interval between the antero-lateral and antero-medial borders. It is extremely narrow and flat in the upper third of its extent; broader and grooved longitudinally in its lower third; it serves for the origin of three muscles: the extensor digitorum longus, extensor hallucis longus, and peroneus tertius.

The posterior surface is the space included between the postero-lateral and the postero-medial borders; it is continuous below with the triangular area above the articular surface of the lateral malleolus; it is directed backward above, backward and medialward at its middle, directly medialward below. Its upper third is rough, for the origin of the soleus; its lower part presents a triangular surface, connected to the tibia by a strong interosseous ligament; the intervening part of the surface is covered by the fibers of origin of the flexor hallucis longus. Near the middle of this surface is the nutrient foramen, which is directed downward.

The medial surface is the interval included between the antero-medial and the postero-medial borders. It is grooved for the origin of the tibialis posterior.

The lateral surface is the space between the antero-lateral and postero-lateral borders. It is broad, and often deeply grooved; it is directed lateralward in the upper two-thirds of its course, backward in the lower third, where it is continuous with the posterior border of the lateral malleolus. This surface gives origin to the peronaei longus and brevis.

Function

The fibula does not carry any significant load (weight) of the body. It extends past the lower end of the tibia and forms the outer part of the ankle providing stability to this joint. It has grooves for certain ligaments which gives them leverage and multiplies the muscle force. It provides attachment points for the following muscles:

Muscle attachments (seen from the front) Gray258.png
Muscle attachments (seen from the front)
Muscle attachments (seen from the back) Gray259.png
Muscle attachments (seen from the back)
MuscleDirectionAttachment [3]
Biceps femoris muscle Insertion Head of fibula
Extensor hallucis longus muscle OriginMedial side of fibula
Extensor digitorum longus muscle OriginProximal part of the medial side of fibula
Fibularis tertius OriginDistal part of the medial side of fibula
Fibularis longus Origin Head and the lateral side of fibula
Fibularis brevis OriginDistal 2/3 of the lateral side of fibula
Soleus muscle OriginProximal 1/3 of the posterior side of fibula
Tibialis posterior muscle OriginLateral part of the posterior side of fibula
Flexor hallucis longus muscle OriginPosterior side of fibula

Clinical significance

Fractures

The most common type of fibula fracture is located at the distal end of the bone, and is classified as ankle fracture. In the Danis–Weber classification it has three categories: [4]

A Maisonneuve fracture is a spiral fracture of the proximal third of the fibula associated with a tear of the distal tibiofibular syndesmosis and the interosseous membrane. There is an associated fracture of the medial malleolus or rupture of the deep deltoid ligament.

An avulsion fracture of the head of the fibula refers to the fracture of the fibular head because of a sudden contraction of the biceps femoris muscle that pulls its site of attachment on the bone. The attachment of the biceps femoris tendon on the fibular head is closely related to the lateral collateral ligament of the knee. Therefore, this ligament is prone to injury in this type of avulsion fracture. [5]

History

Etymology

The word fibula can be dated back to c. 1670 to describe a clasp or brooch – see fibula (brooch) – and was first used in English for the smaller bone in the lower leg c. 1706. It derives from Latin fībula, also meaning a clasp or brooch. The bone was so called because it resembles a clasp like a modern safety pin. [6]

The adjective peroneal referring to the fibula bone or its surrounding structures derives from περόνη  : perónē, the Ancient Greek word for a clasp.

Other animals

Because the fibula bears relatively little weight in comparison with the tibia, it is typically narrower in all but the most primitive tetrapods. In many animals, it still articulates with the posterior part of the lower extremity of the femur, but this feature is frequently lost (as it is in humans). In some animals, the reduction of the fibula has proceeded even further than it has in humans, with the loss of the tarsal articulation, and, in extreme cases (such as the horse), partial fusion with the tibia. [7]

See also

Related Research Articles

<span class="mw-page-title-main">Human leg</span> Lower extremity or limb of the human body (foot, lower leg, thigh and hip)

The leg is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or buttock region. The major bones of the leg are the femur, tibia, and adjacent fibula. The thigh is between the hip and knee, while the calf (rear) and shin (front) are between the knee and foot.

<span class="mw-page-title-main">Ulna</span> Medial bone from forearm

The ulna or ulnal bone is a long bone found in the forearm that stretches from the elbow to the wrist, and when in anatomical position, is found on the medial side of the forearm. That is, the ulna is on the same side of the forearm as the little finger. It runs parallel to the radius, the other long bone in the forearm. The ulna is longer and the radius is shorter, but the radius is thicker and the ulna is thinner. Therefore, the ulna is considered to be the smaller bone of the two bones in the lower arm. The corresponding bone in the lower leg is the fibula.

<span class="mw-page-title-main">Humerus</span> Long bone of the upper arm

The humerus is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a rounded head, a narrow neck, and two short processes. The body is cylindrical in its upper portion, and more prismatic below. The lower extremity consists of 2 epicondyles, 2 processes, and 3 fossae. As well as its true anatomical neck, the constriction below the greater and lesser tubercles of the humerus is referred to as its surgical neck due to its tendency to fracture, thus often becoming the focus of surgeons.

<span class="mw-page-title-main">Fibularis longus</span> Superficial muscle in the lateral compartment of the leg

In human anatomy, the fibularis longus is a superficial muscle in the lateral compartment of the leg. It acts to tilt the sole of the foot away from the midline of the body (eversion) and to extend the foot downward away from the body at the ankle.

<span class="mw-page-title-main">Cuboid bone</span> Bone of the ankle

In the human body, the cuboid bone is one of the seven tarsal bones of the foot.

<span class="mw-page-title-main">Tibia</span> Leg bone in vertebrates

The tibia, also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates ; it connects the knee with the ankle. The tibia is found on the medial side of the leg next to the fibula and closer to the median plane. The tibia is connected to the fibula by the interosseous membrane of leg, forming a type of fibrous joint called a syndesmosis with very little movement. The tibia is named for the flute tibia. It is the second largest bone in the human body, after the femur. The leg bones are the strongest long bones as they support the rest of the body.

<span class="mw-page-title-main">Ankle</span> Region where the foot and the leg meet

The ankle, the talocrural region or the jumping bone (informal) is the area where the foot and the leg meet. The ankle includes three joints: the ankle joint proper or talocrural joint, the subtalar joint, and the inferior tibiofibular joint. The movements produced at this joint are dorsiflexion and plantarflexion of the foot. In common usage, the term ankle refers exclusively to the ankle region. In medical terminology, "ankle" can refer broadly to the region or specifically to the talocrural joint.

<span class="mw-page-title-main">Radius (bone)</span> One of the two long bones of the forearm

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Pott's fracture, also known as Pott's syndrome I and Dupuytren fracture, is an archaic term loosely applied to a variety of bimalleolar ankle fractures. The injury is caused by a combined abduction external rotation from an eversion force. This action strains the sturdy medial (deltoid) ligament of the ankle, often tearing off the medial malleolus due to its strong attachment. The talus then moves laterally, shearing off the lateral malleolus or, more commonly, breaking the fibula superior to the tibiofibular syndesmosis. If the tibia is carried anteriorly, the posterior margin of the distal end of the tibia is also sheared off by the talus. A fractured fibula in addition to detaching the medial malleolus will tear the tibiofibular syndesmosis. The combined fracture of the medial malleolus, lateral malleolus, and the posterior margin of the distal end of the tibia is known as a "trimalleolar fracture".

<span class="mw-page-title-main">Maisonneuve fracture</span> Medical condition

The Maisonneuve fracture is a spiral fracture of the proximal third of the fibula associated with a tear of the distal tibiofibular syndesmosis and the interosseous membrane. There is an associated fracture of the medial malleolus or rupture of the deep deltoid ligament of the ankle. This type of injury can be difficult to detect.

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<span class="mw-page-title-main">Talus bone</span> One of the foot bones that forms the tarsus

The talus, talus bone, astragalus, or ankle bone is one of the group of foot bones known as the tarsus. The tarsus forms the lower part of the ankle joint. It transmits the entire weight of the body from the lower legs to the foot.

<span class="mw-page-title-main">Ankle fracture</span> Medical condition

An ankle fracture is a break of one or more of the bones that make up the ankle joint. Symptoms may include pain, swelling, bruising, and an inability to walk on the injured leg. Complications may include an associated high ankle sprain, compartment syndrome, stiffness, malunion, and post-traumatic arthritis.

<span class="mw-page-title-main">Inferior tibiofibular joint</span>

The inferior tibiofibular joint, also known as the distal tibiofibular joint, is formed by the rough, convex surface of the medial side of the distal end of the fibula, and a rough concave surface on the lateral side of the tibia.

<span class="mw-page-title-main">Posterior tibiofibular ligament</span>

The posterior ligament of the lateral malleolus is smaller than the anterior ligament of the lateral malleolus and is disposed in a similar manner on the posterior surface of the syndesmosis. It connects the tibia and fibular on the inferior part of both bones.

<span class="mw-page-title-main">Interosseous membrane of leg</span>

The interosseous membrane of the leg extends between the interosseous crests of the tibia and fibula, helps stabilize the Tib-Fib relationship and separates the muscles on the front from those on the back of the leg.

<span class="mw-page-title-main">Malleolus</span> Ankle bone protrusion

A malleolus is the bony prominence on each side of the human ankle.

<span class="mw-page-title-main">Deep fascia of leg</span> Forms a complete investment to the muscles

The deep fascia of leg, or crural fascia forms a complete investment to the muscles, and is fused with the periosteum over the subcutaneous surfaces of the bones.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

<span class="mw-page-title-main">Crus fracture</span>

A crus fracture is a fracture of the lower legs bones meaning either or both of the tibia and fibula.

References

PD-icon.svgThis article incorporates text in the public domain from page 260 of the 20th edition of Gray's Anatomy (1918)

  1. ↑ OED 2nd edition, 1989.
  2. ↑ Entry "fibula" in Merriam-Webster Online Dictionary .
  3. ↑ Bojsen-Møller, Finn; Simonsen, Erik B.; Tranum-Jensen, Jørgen (2001). Bevægeapparatets anatomi[Anatomy of the Locomotive Apparatus] (in Danish) (12th ed.). pp. 364–367. ISBN   978-87-628-0307-7.
  4. ↑ Mcrae, Ronald; Esser, Max (8 April 2008). Practical Fracture Treatment (Fifth ed.). p. 382. ISBN   978-0-443-06876-8.
  5. ↑ Gottsegen, CJ; Eyer, BA; White, EA; Learch, TJ; Forrester, D (2008). "Avulsion fractures of the knee: imaging findings and clinical significance". Radiographics. 28 (6): 1755–1770. doi:10.1148/rg.286085503. PMID   18936034.
  6. ↑ etymonline.com
  7. ↑ Romer, Alfred Sherwood; Parsons, Thomas S. (1977). The Vertebrate Body. Philadelphia, PA: Holt-Saunders International. p. 205. ISBN   0-03-910284-X.
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