FIBULA

The fibula is the lateral and smaller bone of the leg.. it is also homologous with the ulna of
forearm. And it’s very thin as compared to the tibia. In Latin, the word Fibula means pin. As we
can see it is rightly named because it is a long pin like bone… it’s a long slender post –axial bone
of the leg and it does not take part in the transmission of the body weight.

Fibula subserves two important functions.

1) It provides attachments – muscles
2) Its lower end along with the lower end of tibia forms a socket , it’s called tibiofibular
mortise to hold the talus in place.

SLIDE DETERMINATION and ANATOMICAL

POSITION
Now let’s take a look at the side determination of the bone…the side of fibula can be determined
by holding it vertically like this ..

 It’s round end called head is directed upward

 Its relatively flattened end is directed downward.
 A triangular articular facet on its lower end faces medially
 A depression at the lower end which is also called as mallleolar fossa lies behind
and below the triangular articular facet at this end.
PARTS
When it comes to the parts of fibula, as we can see now, it’s a long bone and it consists of three
parts.

 The upper end

 The lower end
 Intervening shaft

Now lets look at each parts one by one.

Firstly,

 The upper end also known as head , is round and presents a circular articular facet.
An upward projection posterolateral to this facet is called styloid process .
 The shaft is described to have anterior, interosseous, and posterior borders; and
medial, lateral, and posterior surfaces. However, only interosseous border is clear-
cut other borders and surfaces spiral so that it is difficult ascertain. None of them
remains strictly in the position implied by its name. Therefore, making an attempt to
identify them is just wastage of time.
 The lower end is flattened and bears a triangular articular face on its medial surface
for articulation with the talus. Behind and below this is a roughened fossa called
malleolar fossa.
FEATURES
Now let’s look at the features of fibula. It has an upper end, a shaft and a lower end.

 The upper end or head is slightly expanded in all directions. The superior surface
bears a circular articular facet which articulates with the lateral condyle of the tibia.
The apex of the head or the styloid process projects upwards from its posterolateral
aspect. The constriction immediately below the head is known as the neck of the
fibula .
 The shaft shows considerable variation in its form because it is moulded by the
muscles attached to it. It has three borders- Anterior, posterior, and interosseous
and three surfaces- medial, lateral and posterior
 borders
The anterior border begins just the anterior aspect of the head. At its lower end, it
divides to enclose an elongated triangular area which is continuous with the lateral
surface of the lateral malleolus.
The posterior border is rounded. Its upper end lies in line with the styloid process.
Below, the border is continuous with the medial margin of the groove on the back
of the lateral malleolous.
The interosseous or medial border lies just medial to the anterior border, but on a
more posterior plane. It terminates below at the upper end of a roughened area
above the talar facet of the lateral malleoulus. In its upper two –thirds, the
interosseous border and maybe indistinguishable from it.
ATTACHMENTS AND RELATIONS
Now we can move on and see the attachments and features of the bone fibula.

1) The medial surface of the shaft gives orgin to:

a) The extensor digitorum longus, from the whole of the upper one-fourth. And from the
anterior half of the middle two-fourths.
b) The extensor halluces longus, from the posterior half of the middle two-fourth
c) The peroneus tertius, from its lower one-fourth

2) The lateral surface of the shaft gives orgin to:

a) Peroneus longus (PL) . from its upper one-third, and posterior half of the middle one-
third
b) The peroneus brevis (PB) from the anterior half of its middle one-third..and the whole
of lowrer one-third..the common peroneal nerve terminates in relation to the neck of
fibula.

3) The part of the posterior surface between the medical crest and the posterior border
gives origin to :

a) Soleus from the upper one-fourth

b) Flexor halluces longus from its lower three-fourths

4) The part of the posterior surface between the medical crest and the interosseous border
, the grooved part, gives orgine to the tibialis posterior

5) The head of the fibula receives the insertion of the biceps femoris on the anterolateral
slope of the apex. This insertion is C shaped. The fibular coladral ligament of the knee
joint is attached within the C shaped area. The origins of the exterior digitorum, the
peroneus longus, and the soleus , extend on the corresponding aspects of the head .

6) The capsular ligament of the superior tibiofibular joint is attached around the articular
facit.
7) The anterior border of the fibula gives attachment to

a) Anterior inter mascular septum of the leg

b) Superior extensor retinaculm, to lower part of the anterior margin of triangular area.
c) Superior peronial retinaculm, to the lower part of the posterior margin of triangular
area

8) The posterior border gives attachment to the posterior intermuscular septum.

9) The interosseous border gives attachments to the interosseous membrant. The

attachment leaves a gap at the upper end for passage of the anterior tibial vessels and
a gap at lower end for passage of perforating branch of perennial artery.

10) The triangular area above the medical surface of the lateral malleolus gives attachment
to :

a) The interosseous tibiofibular ligament, in the middle. The joint between lower ends
between tibia and the fibula is called syndesmoses which means binding together in
greek
OSSIFICATION
Now lets talk about the ossifications of fibula bone

The fibula ossifies from one primary and two secondary centers. The primary center for the shaft
appears during the eighth week of intrauterine life. A secondary center for the lower end appears
during the first year, and fuses with the shaft by about sixteen years. A secondary center for the
upper end appears during the fourth year, and fuses with the shaft by about eighteen years.

The fibula violates the law of ossification because the secondary center which appears first in the
lower end fuses earlier and not later. The reason for this violation are:

1) The secondary center appears first in the lower end because it is a pressure epiphysis
(law states that pressure epiphysis appears before the traction epiphysis).
2) The upper epiphysis fuses last because this is the grooving end of the bone. It continues
to grow afterwards along with the upper end of tibia which is a grooving end.
CLINICAL
Finally let’s discuss about the clinical points of fibula bone

 Sometimes a Surgeon takes a piece of bone from the part of the body and uses it
to repair a defect in some other part. This is called a bone graft. For this purpose,
pieces of bone are easily obtained from the subcutaneous medial aspect of tibia
and shaft of fibula.
 If the foot get’s caught in a hole in the ground, there is forcible abduction and
external rotation. In such an injury, first there occurs a spiral fracture of lateral
malleolus, then fracture of the medial malleolus. Finally the posterior margin of the
lower end of tibia shears off. These stages termed 1st ,2nd and 3rd degrees of pott’s
fracture.
 The upper and lower ends of the fibula are subcutaneous and palpable.
 The common peroneal nerve can be rolled against the neck of fibula. The nerve is
commonly injured here resulting in foot drop.
 Fibula is an ideal spare bone for a bone graft.
 Though fibula does not bear any weight, the lateral malleolus and the ligaments
attached to it are very important in maintaining stability at the angle joint.