The Tibiofibular Joints
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Knee joint | Main Anatomy Index | Joints of
ankle and foot
Last updated 30 March 2006
The Tibiofibular Joints (pp. 486-7)
- The tibia and fibula articulate at their proximal and distal ends.
- Movement at the proximal tibiofibular joint is impossible without movement at the distal
one.
The Proximal
(Superior) Tibiofibular Joint
- This is a plane type of synovial joint between the head of the fibula and lateral
condyle of the tibia.
Articular
Surfaces of the Proximal Tibiofibular Joint
- The flat, oval-to-circular facet on the head of the fibula articulates with a similar
facet located posterolaterally on the inferior aspect of the lateral condyle of the tibia.
Movements of the
Proximal Tibiofibular Joint
- Slight movement occurs at the superior tibiofibular joint during dorsiflexion of the
foot at the ankle joint.
- This presses the lateral malleolus laterally and causes movement of the body and head of
the fibula. Some movement of the joint also occurs during plantarflexion of the foot.
The Articular
Capsule of the Proximal Tibiofibular Joint
- The fibrous capsule surrounds the joint and is attached
to the margins of the articular facets on the fibula and tibia.
- It is strengthened by the anterior and posterior ligaments of the
head of the fibula.
- The fibres of these ligaments run superomedially from the fibula to the tibia.
- The tendon of the popliteus muscle is intimately related to the posterosuperior aspect
of the proximal tibiofibular joint.
- The synovial membrane lines the fibrous capsule. The
pouch of synovial membrane passing under the tendon of the popliteus muscle, known as the popliteus bursa, sometimes communicates with the synovial
cavity of the proximal tibiofibular joint though an opening in the superior part of the
synovial capsule.
- Consequently, the proximal tibiofibular joint may be indirectly in communication with
the synovial cavity of the knee joint.
Blood Supply of the Proximal Tibiofibular Joint
- The articular arteries are derived from the inferior lateral genicular and anterior
tibial recurrent arteries.
Nerve Supply of the Proximal Tibiofibular Joint
- The articular nerves are derived from the common fibular (peroneal) nerve and the nerve
to the popliteus muscle.
The Distal (Inferior)
Tibiofibular Joint
- This is a fibrous joint of the syndesmosis type. It is located between the inferior ends
of the tibia and fibula.
Articular
Surfaces of the Distal Tibiofibular Joint
- The rough, convex, triangular articular area on the medial surface of the inferior end
of the fibular articulates with a facet on the inferior end of the tibia.
- A small superior projection of the synovial capsule of the ankle joint extends into the
inferior part of the distal tibiofibular joint.
- A strong interosseous ligament continuous superiorly
with the interosseous membrane, forms the principal connection between the tibia and
fibula at this joint.
- It consists of strong bands that extend from the fibular notch of the tibia to the
medial surface of the distal end of the fibula.
- The strong anterior and posterior tibiofibular ligaments
also strengthen the distal tibiofibular joint anteriorly and posteriorly.
- They extend from the border of the fibular notch of the tibia to the anterior and
posterior surfaces of the lateral malleolus, respectively, respectively.
- The inferior, deep part of the posterior tibiofibular ligament is called the transverse tibiofibular ligament. This strong band closes the
posterior angle between the tibia and fibula.
Stability of the Distal
Tibiofibular Joint
- This articulation forms a strong union between the distal ends of the tibia and fibula;
much of the strength of the ankle joint is dependent on this union.
Movement of the Distal
Tibiofibular Joint
- Slight movement of the distal tibiofibular joint occurs to accommodate the talus during
dorsiflexion of the foot at the ankle joint.
Blood Supply of the Distal Tibiofibular Joint
- The articular arteries are derived from the perforating branch of the fibular (peroneal)
artery and the medial malleolar branches of the anterior and posterior tibial arteries.
Nerve Supply of the Distal Tibiofibular Joint
- The articular nerves are derived from the deep fibular (peroneal), tibial, saphenous
nerves.
Trimalleolar Fracture
- The posterior tibiofibular ligament is much stronger than the anterior tibiofibular
ligament. In severe ankle injuries, the posterior ligament may avulse the posteroinferior
part of the tibia.
- In these cases the fracture enters the ankle joint. If, in addition, the medial and
lateral malleoli are fractured, the injury is referred to as a "trimalleolar
fracture" (i.e., a fracture of both the malleoli and the posterior part of the
inferior border of the tibia).