Fibula

18 Fibula



Orientation and general presentation (Figs 18.1 & 18.2)


The fibula is lateral and posterior to the tibia. The distal epiphysis (1) is flatter than the proximal epiphysis (2). The distal epiphysis shows the lateral malleolus (FAL). The articular facet of the talofibular joint (3) is oriented medially, whereas the malleolar fossa (4) of the lateral malleolus is located behind the joint surface. The proximal epiphysis, or fibula head (2), is separated from the diaphysis by the neck of the fibula (FNE). The fibula head has a styloid process (5) pointing upwards and showing a sharp fibula apex (FAX). Vertically below the lateral aspect of the head, the lateral edge (blue line) runs downwards.


image

Figure 18.1 Fibula (3D model).


A Fibula and tibia (semitransparent): lateral view. B Isolated fibula: medial view.


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Figure 18.2 Fibula (anatomic specimen).


A General view, medial. B Proximal epiphysis: lateral view. C Distal epiphysis: lateral view.



Fibula – ApeX of the styloid process (FAX)[R,L]



Landmark FAX


Bony eminence located on the dorsal aspect of the fibula head (see Fig. 18.1, structure 2). Both the biceps femoris muscle and the fibular collateral ligament insert on the head next to the styloid process (see Figs 18.1 & 18.2).



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image Subject lying: The subject is lying supine, knee flexed (about 90°), with the palpator standing slightly laterally in front of the knee.


Subject standing: The palpator kneels, facing the flexed knee of the subject, who is asked to put his or her bodyweight on the limb that is not being palpated.


Follow the tendon of the biceps femoris muscle (blue arrow) with your index finger until you reach its insertion.



image

image FAX is the most lateral and posterior part of the fibula head, next to the tendon.




Manual palpation tip



• The head of the fibula might be seen better under the skin when the knee is flexed with an internal rotation of the shank.


image Observe the proximal epiphysis of the fibula from a lateral view.

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Sep 9, 2016 | Posted by in MANUAL THERAPIST | Comments Off on Fibula

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