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The fibula is counted among the long bones. It lies along the tibia with which it is connected at the top and bottom. It is a relatively thin bone, therefore fractures are one of its most common injuries. Find out how the fibula is built, what functions the fibula does, what diseases can affect the fibula and how the fibula is used in medicine.
The fibula(Latin: fibula) is an even long bone that forms, together with the tibia, the skeleton of the lower leg. The fibula is the site of attachment of numerous muscles of the lower limb. Additionally, the distal end of the fibula is part of the ankle joint. The most common diseases associated with the fibula include fractures resulting from excessive overstrain or trauma.
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fibula - structure
The fibula is a long but rather thin bone, located on the side of the lower leg. The fibula is directly adjacent to the much more massive tibia, forming the skeleton of the shin with it. There are two types of connections between the fibula and the tibia.
The first one is the tibio-sagittal joint, which connects the closer ends of these bones. The tibiofibular joint is in close proximity to the knee, although it has no connection to it. The end closer to the fibula is therefore not part of the knee joint and does not participate in its movements.
The second connection between the fibula and the tibia is the so-called the interosseous membrane of the shin, passing downwards into the tibiofibular ligament. This membrane is made of very durable connective tissue. Through it, the tibia and fibula are joined together along their entire length.
Both the tibiofibular joint and the interosseous membrane of the shin contribute to the tight connection of both bones and prevent them from moving towards each other. For this reason, the mobility of the fibula in relation to the tibia is very limited (it is difficult to move the fibula itself, without the rest of the shin).
The lower part of the fibula is the lateral bone that can be easily felt under the skin. The distal end of the arrow connects with two other bones - the tibia and the talus bone, formingcollectively, the upper ankle joint (also called the ankle joint).
The upper ankle joint allows up and down movements of the foot (dorsal and plantar flexion), such as walking on toes and heels. Therefore, the fibula is not involved in the function of the knee, but is an essential part of the ankle joint.
In addition to permanent connections with the tibia and participation in the construction of the ankle joint, the fibula is a site of attachment of numerous muscles. The biceps muscle of the thigh, which is one of the largest muscles of the lower limb, is attached to the closer end of the arrow.
In the lower parts of the fibula are the attachments of the shin muscles, including the extensors of the toes, peroneal muscles and soleus muscles. Most of them are involved in the mobility of the ankle joint.
The lower part of the fibula is also attached to the articular ligaments, whose task is to stabilize the lateral part of the ankle joint.
There are many blood vessels and nerves in the immediate vicinity of the fibula. Along the arrow, the peroneal artery is located, supplying blood both to the bone itself and to the muscles of the lower leg nearby.
The top of the arrowhead is reached by the common sagittal nerve, which then divides into two branches: superficial and deep sagittal nerve. These nerves enable the lateral muscles of the lower leg and the foot extensors to move. In terms of sensory innervation, thanks to them it is possible to receive stimuli from the dorsal surface of the foot and the lateral part of the shin. Peroneal nerve injury is one of the possible complications of fibula injuries
fibula - functions
Although the fibula is an important component of the shin skeleton, its mechanical function is relatively small. An arrow is an example of a bone that carries virtually no load.
The main role of the arrow is to build and stabilize the ankle joint, to provide an attachment site for the muscles of the shin and to perform supporting functions for the much more stressed tibia. The tendons of the muscles attached to the arrow are responsible for the great mobility of the ankle joint. In the lower part of the fibula, three sagittal ligaments begin to stabilize the lateral part of the ankle.
The lack of significant mechanical loads affecting the arrow has become the reason for inventing interesting ways of using this bone in medicine.
Fibula - medical use
The fibula does not have important functionssupports for the rest of the skeleton. The amount of bone tissue that builds the arrow is large in relation to the loads it carries. For this reason, the fibula has become a valuable source of material for bone transplants. Clinical observations have shown that small fragments of the fibula can be successfully removed and implanted in other locations without any significant loss in the function of the shin.
The fibula is primarily used in maxillofacial surgery, including filling bone defects within the mandible. Mandibular reconstruction with the use of fragments of the fibula is performed, among others, by in patients with severe craniofacial injuries or as part of the treatment of mandibular head tumors.
fibula - diseases
Fibula-related conditions have many different causes. Within the fibula, as well as throughout the skeleton, there may be tumors, infections, and symptoms of metabolic diseases (including osteoporosis). However, by far the most common cause of fibula damage are injuries, leading to excessive overload and, in extreme cases, to fractures of this bone.
Congenital defects, usually diagnosed in childhood, are among the rare diseases of the fibula.
Fracture of the fibula
Symptoms, course and treatment of a fibula fracture depend on the location of the injury, the relative position of the bone fragments and the presence of complications (including vascular and nerve damage). For the diagnosis of fibula fractures, X-rays are used, usually made in two projections.
Suspicion of damage to nearby soft tissues may require more advanced imaging tests, incl. magnetic resonance imaging.
Fracture in the middle of the fibula does not always require the limb to be put in a plaster. The tibia located nearby can in many cases act as a scaffold for the healing dart, thanks to which only temporary immobilization of the limb is enough to heal.
There is a much greater risk of complications in the case of fractures of the proximal or distal end of the arrow. Such injuries may require surgery. The peroneal nerve runs near the proximal end of the fibula, which may be damaged during an injury to this area.
A typical symptom of a rupture of the peroneal nerve is the foot descending, i.e. the inability to dorsally flex the foot. The patient then travels the so-called walking with a cocksucker, lifting the whole leg high and limply lowering the forefoot while taking a step.
If while breakingin the proximal end of the fibula, the peroneal nerve is torn, it is necessary to surgically fix it, and then appropriate rehabilitation.
Other indications for invasive treatment of fibula fractures include
- open fractures,
- fractures complicated by damage to blood vessels,
- as well as unstable fractures involving the ankle.
The method of treating lateral ankle fractures depends on the location of the fracture fracture, as well as the degree of damage to the remaining structures within the ankle joint (ligament rupture, mutual displacement of the remaining bones). The lightest cases only require immobilization and relieving the limb.
Fractures with displacement or serious damage to nearby soft tissues usually require surgical treatment. Although the most common cause of fractures of the arrowhead are sudden injuries (traffic accidents or sports accidents), fractures due to prolonged overloading also occur in this bone. I am talking about the so-called fatigue fractures, occurring most often in people undertaking highly strenuous physical exertion.
The symptom of a fatigue fracture of the fibula is pain, mainly during movement. The diagnosis of a fatigue fracture is an indication for the relief of the fibula necessary for its healing. It is also necessary to properly rehabilitate and significantly reduce training loads.
Congenital defects of the fibula
Congenital malformations of the fibula are relatively rare. An example of such a disease is fibular hemimelia, which is a congenital lack of the fibula. The absence of the fibula results in a limb shortening and a significant deformation of the foot, ankle and knee joints.
Treatment of sagittal hemimelia requires the use of prostheses that reproduce the correct structure of the lower leg. In the case of accompanying foot defects, the scope of reconstructive procedures is extended accordingly.
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