What Is the Distal Fibula?

The fibula perone is one of the long bones of the lower leg and calf. Thinner on the outside of the calf. The upper end is called the fibula head, and the joint surface is connected with the fibula joint surface of the tibia. The lower end is called the lateral malleolus, and the medial side has a flat lateral malleolus joint surface that participates in the formation of the ankle joint. This bone is slender, supporting and supporting. This bone injury is more common, and simple fibula fractures have less effect on the weight bearing of the lower limbs. However, there are many nerves and blood vessels in the tibia and fibula, which are easy to be damaged at the same time, so it should be treated with great care.

The fibula perone is one of the long bones of the lower leg and calf. Thinner on the outside of the calf. The upper end is called the fibula head, and the joint surface is connected with the fibula joint surface of the tibia. The lower end is called the lateral malleolus, and the medial side has a flat lateral malleolus joint surface that participates in the formation of the ankle joint. This bone is slender, supporting and supporting. This bone injury is more common, and simple fibula fractures have less effect on the weight bearing of the lower limbs. However, there are many nerves and blood vessels in the tibia and fibula, which are easy to be damaged at the same time, so it should be treated with great care.

Chinese name

fibula

Foreign name

perone

Nature

Calf bones

Pinyin

féi g

Fibula imaging structure

1. The fibula is in the right position (Figure 6-1-35). On the fibula orthotopic film, the fibula head partially overlaps with the lower part of the lateral tibial condyle. The upper end of the small head of the fibula protrudes upward, which is called the fibula styloid process. The cancellous texture of the fibula's small head is relatively sparse, and sometimes a local density reduction zone may appear.

The fibula shaft is particularly slender, showing a typical tubular bone shadow, with a thicker outer cortex and a thinner medial cortex, and sometimes a lighter density edge appears as an interosseous epiphysis.

The lower end of the fibula constitutes the lateral malleolus, which has a triangular shape with the tip facing downwards, and its inner surface corresponds to the talar block and participates in the formation of the ankle joint. At the lower end of the lateral malleolus, a lighter sulcus is sometimes seen as the lateral malleolus sulcus. Above the lateral malleolus, the fibula overlaps or corresponds to the lower end of the tibia with a gap.

2. Lateral fibula (Figure 6-1-36). The anterior part of the fibula head overlaps with the tibia, and the fibula backbone is a typical long tubular bone. The lateral malleolus goes down through the ankle joint into the talar pulley shadow. In the shadow that overlaps the talar tackle, the medial malleolus is anterior and the lateral malleolus is posterior.

Figure 6-1-35 Tibia and Fibula Upright

1, medial tibial condyle 2, lateral tibial condyle 3, fibula head 4, intertibia condyle 5, medial malleolus 6, lateral malleolus

Figure 6-1-36 Lateral position of tibia and fibula

1, fibula head 2, tibial condyle 3, intercondylar bulge 4, tibial tuberosity 5, lower end of tibia 6, lateral ankle

1 fibula head

2 lines

3 Fibula body

4 lateral ankle

Fibula -related diseases and treatment

1. The incidence of fibula fractures is relatively high clinically. Most of them are combined with tibial fractures in ankle fractures, tibiofibular fractures, including specific types of pilon fractures.

2. Classification: According to the different situations of fibula fractures, it can be divided into: 14 cases of fibula fractures (fracture line 8cm above fibula tip), simple lateral malleolus fractures (fracture line 8cm below fibula tip) 18 cases, 26 cases of ankle fractures (fibula fracture line less than 8cm from fibula tip), ankle fractures (fibula fracture line more than 8cm from fibula tip) 40 cases, tibiofibular fracture (tibia and fibula fracture line at the same level) 25 cases, There were 38 cases of tibiofibular fractures (different levels of tibiofibular fracture line) and 21 cases of iliac Pilon fractures. All fractures were closed fractures.

Fibula treatment

Fracture of the sacral fibula: Simple fibula fractures are mostly caused by direct violence, and the fractures are transverse, oblique or with sphenoid bone. This type of injury generally does not involve rotational violence, the interstitial membrane is more complete, the displacement is mainly shortened and overlapping, the local soft tissue is thick, the blood flow is rich, and the conservative treatment of fracture healing is high.

Fibula fractures in sacroiliac joint fractures: Academia believes that non-surgical fractures of the lateral malleolus without medial malleolus fractures or medial ligament injuries can be treated non-surgically. If there is a fracture of the medial malleolus and hind ankle, the lateral malleolus fracture is reduced and fixed after reduction Hind and medial malleolus fractures. A simple avulsion fracture of the lateral malleolus does not affect the stability of the ankle joint. Most of the lateral collateral ligaments are intact, and more plaster casts can be used to achieve better results.

(3) Fibula fractures in tibia and fibula fractures; fracture lines with different levels of tibia and fibula fractures are mostly of type A1 in the AO classification. Fracture violence is small. The tibia and fibula fracture lines are spiral. The tibia fracture line extends from the bottom to the top. Fibula. Fracture lines are located in the upper and middle segments, and fractures of the tibia and fibula at the same level are mostly located in the lower calf 1/3, with a smaller fracture surface, less soft tissue wrapping, and relatively slow healing. We advocate fixing the fibula. For simple fractures, fixing the tibia and fibula at the same time can increase the stability of the fracture, especially to overcome the non-rotational instability caused by direct violence, and support early weight bearing is conducive to fracture healing. Although the tension side of the tibia is located on the anterior medial side, the tension side is located on the outside for the entire calf, so bilateral fixation is also reasonable. However, in some patients, the fibula healed but the tibia was not healed after the fixation, and it was finally solved by re-operative bone grafting. On the contrary, when the tibia was fixed, a fibula nonunion occurred in a patient with fibula immobilization, which caused local soreness and walking weakness. After the tibia is healed, the intramedullary nail is removed and the fibula is fixed to achieve healing. For tibial comminuted fractures, the anatomical reduction and fixation of the fibula is even more important. It can restore the length to correct the rotation and provide a reference for tibial reduction. In poor conditions, it can even fix only the fibula. As a final treatment, it also achieves good results.

Fibula fractures in Pilon fractures: Pilon fractures are special fractures involving the tibiofemoral joint surface caused by vertical violence. The lateral structure of the ankle joint is the key to maintaining the stability of the ankle joint. Therefore, the surgical treatment of the fibula is very important. After the fibula is fixed, it is conducive to the stability of the ankle joint and to the reduction and fixation of the tibia [12]. The specific functions are restoring the anatomic length of the limb; using the traction reduction effect of the lower tibiofibular ligament on the tibial fracture end to stabilize the tibial fracture end; the support effect after the fibula is stabilized and increasing the distal tibial cancellous bone fixation The stability.

For the treatment of fibula fractures, the use of internal fixation surgery alone will have a certain impact on the patient, such as causing greater damage to the patient's local soft tissue, resulting in very serious postoperative complications. Treatment of patients with fibula fractures with external fixation has a poor stabilization effect. In addition, external fixation surgery can lead to a variety of adverse symptoms such as joint adhesions, stiffness, and dysfunction. In recent years, internal and external fixation combined therapy has been used to treat patients with fibula fractures. Local incisions are used to reduce the fractures that affect the articular surface under direct vision. Large fixed span and strong randomness. Treatment of fibula fractures with internal and external fixation can not only significantly improve the stability of the fracture site, but also significantly reduce the probability of postoperative complications. Furthermore, it can effectively avoid various defects of conservative treatment and simple internal fixation, and reduce the surgical pain suffered by patients.