What Is the Tibialis Posterior?

The tibia is the long bone on the inner side of the calf, divided at one end. The proximal end of the tibia is swollen, protruding to the sides to become the medial malleolus and lateral condyle.

The tibia is the long bone on the inner side of the calf, divided at one end. The proximal end of the tibia is swollen, protruding to the sides to become the medial malleolus and lateral condyle.

Chinese name

Tibia

Foreign name

tibia

Pronunciation

jìng g

Definition

Calf one

lie in

Inner side of calf

Function

Support weight

Related

"Lingshu · Meridian"

Zhuyin

Tibia Anatomy

The upper surface of the two condyles is smooth as an articular surface, the intercondylar area is between the two condyles, and the middle is the intercondylar bulge. A rough bulge in front of the proximal end of the tibia is called the tibial tuberosity as the site of patellar ligament attachment. Behind the lateral condyle there is a circular fibula joint surface associated with the fibula head.

The cross section of the tibial body is triangular, and its anterior edge and anterior medial length are located under the skin, which is the most prone to fracture. The upper part of the back of the tibial body has a significantly oblique soleus muscle line (sacral line), which is the soleus muscle attachment place.

The distal end of the tibia is swollen, and its cross section is square. A concave articular surface on the outside is called the fibular notch and the fibula-related segment to form a tibiofibular connection. There is a medial malleolus protruding downward on the inside. The lower end of the distal end of the tibia is smooth and covered with articular cartilage. It forms the joint socket of the ankle joint with the external articular surface of the medial malleolus and the internal articular surface of the lateral malleolus.

Traumatic fractures of the tibia are common; osteomyelitis and bone tumors are also common.

Tibia imaging structure

1. Tibia upright. The upper end of the bone is composed of the tibial inner and lateral condyles and tibial tuberosity. On the orthophoto, the appearance of the medial and lateral condyles is similar, except that the lateral edge of the upper end of the tibia is more inclined, while the medial edge is approximately square. The superior articular surfaces on both sides of the tibial condyles are flat, corresponding to the medial and lateral femoral condyles, respectively. The lower part of the lateral condyle overlaps with the small head of the fibula, forming the tibiofibular joint. The trabecular bone of the upper end of the tibia is obvious, and the transverse sacral line is also common. The tibial tuberosity in the middle of the metaphysis is usually not visualized on the orthophoto.

The tibial diaphysis is a typical tubular bone shadow with obvious cortex on both sides and a bone marrow cavity. The lower end is slightly swollen, and its lower articular surface corresponds to the ankle joint corresponding to the talus. The medial malleolus shadow protrudes downward from the inner side of the lower end, and it also participates in the formation of the ankle joint. The outer surface of the lower end of the tibia overlaps with the lower end of the fibula, and sometimes there are gap shadows connected by ligaments. The trabeculae at the lower end of the tibia are clear and sometimes the sacral line is also seen.

2. Tibia lateral position. On the tibial lateral film, the inner and outer condyles of the upper end overlap. The cortex of the anterior margin of the upper end of the tibia is obviously bulged forward, which is tibia tuberosity. The trailing edge overlaps with the small head of the fibula and occasionally the tibiofibular joint space. The frontal cortex of the diaphysis is significantly thickened, which is the anterior tibia shadow. The posterior cortex is thin and often overlaps the fibula shaft. The lower end of the tibia is swollen, and the inferior articular surface corresponds to the ankle joint corresponding to the talus pulley, and the joint space is obvious. The medial malleolus shadow at the lower end of the tibia is triangular, and the tip extends down into the shadow of the talus pulley. In addition, the ankle joint space overlaps the fibula lateral malleolus.

Tibia related diseases and treatment

The tibial plateau is a load-bearing structure of the knee joint. Its fracture is an intra-articular fracture. It is most commonly caused by a car accident and a fall injury from the height.

1. Incision and reduction and internal fixation are still the main methods for treating tibial plateau fractures. The purpose of internal fixation for tibial plateau fractures is not only to reduce fractures, restore the knee joint line of force, but also to restore knee function. Therefore, while the fracture is firmly fixed to ensure healing, the tibial plateau articular surface should be dissected and reset as far as possible to allow the limb to perform early, painless and active activities to reduce the occurrence of fracture complications. The traditional steel plate internal fixation surgery mainly emphasizes the stability of fracture fixation. Bone biological factors are usually ignored, reflecting the large surgical incision, wide exposure range, and severe blood supply damage at the fracture end. The core principle of minimally invasive percutaneous plate fixation (MIPPO) is to protect the biological environment of fracture healing, especially to protect the blood supply around the fracture end. MIPPO uses the concept of "internal fixation stent" to restore the fracture by using tendon reduction and indirect reduction technology. Bridges are fixed with ordinary or special design steel plates. The advantage is that the blood supply at the fracture site can be preserved to the maximum extent and fracture healing can be promoted. Reduce the risk of infections and re-fractures.

2. External fixation technology Tibial plateau fractures caused by high-energy trauma are often accompanied by bone, muscle, and skin defects. External fixation brackets are often used for clinical treatment because external fixation brackets have less trauma and have no iatrogenic aggravation of the fracture end Blood flow, more in line with the characteristics of the physiological process of fracture healing, etc., has also become an indispensable method in the hands of orthopedists. For those tibial plateau fractures caused by high-energy trauma that may require internal fixation in the future, it is still recommended to use a temporary external fixation stent to promote fracture reduction and fixation, and to gain time for soft tissue healing, and there is no clinical evidence to indicate future internal fixation site infections From the temporary external fixation bracket. Ilizarov external fixation stent is suitable for patients with type II and III open fractures with severely comminuted tibial plateau fracture joint surfaces caused by high-energy trauma, or patients whose internal fixation may be life-threatening and large-scale pollution will increase infection and cause loss of limbs. The advantages of Ilizarov external fixation stent are low secondary surgery rate, short hospital stay, fewer complications, and no significant difference in fracture healing rate compared with open reduction and internal fixation.