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StatPearls . Endowment Island (FL): StatPearls Publishing; 2021 Jan-.


Anatomy, Bony Pelvis and also Lower Limb, Fibula

Marco Gupton; Akul Munjal; Michael Kang.

Author Information


The fibula is a long bone in the lower extremity that is positioned ~ above the lateral side of the tibia. The fibula is lot smaller and also thinner 보다 the tibia. It is located simply behind the tibial head in ~ the knee joint and also then runs under the lateral element of the leg until it will the fishing eye joint. A ridge top top the medial surface ar of the fibula creates the interosseous border where the fibula is linked to the tibia via the interosseous membrane. This link forms a syndesmotic joint, an interpretation it has very little mobility.<1><2><3>

The framework of the fibula deserve to be damaged down right into the head, neck, shaft, and distal finish of the fibula. As the head becomes narrow distally, the fibular neck is formed. The fibular pillar lies distal to the neck and also has 3 surfaces, lateral, medial, and posterior. The shape of the fibular column is identified by the muscle attachments. Initially, the is a triangular shape and also distally becomes much more irregularly shaped. The distal finish of the fibula develops the lateral malleolus i m sorry articulates through the lateral talus, creating part of the lateral ankle. The posterior and also lateral tibia type the posterior and medial malleolus, respectively. 

Like the tibia, the fibula is ossified in three areas, in the middle and at either end of the epiphysis. Ossification of the fibula begins in the column at approximately the eighth week of gestation and also then extend to one of two people end. The procedure of ossification is finish by the second decade of life. Both end of the fibula continue to be cartilaginous.

Structure and also Function

Unlike the tibia, the fibula is not a weight-bearing bone. That main function is to incorporate with the tibia and carry out stability to the fishing eye joint. The distal end of the fibula has actually several grooves for ligament attachments which climate stabilize and provide leverage during the ankle movements. The lateral (fibular) collateral ligament attaches come the lateral side of the fibular head. This ligament provides knee stability. However, the fibula itself has actually a little duty in giving knee stability.

Blood Supply and Lymphatics

The blood it is provided to the fibula is indigenous the fibular artery (also known as the peroneal artery) which has actually many little branches which it is provided the diaphysis. The epiphysis and also the proximal fibular head are provided by branches the the anterior tibial artery. The periosteum also receives numerous small branches indigenous the fibular artery and also supplies the rest of the bone. It is essential to know the blood it is provided of the fibula due to the fact that this bone is often used together a graft for repair of the mandible.


The fibula"s lateral surface, deep fascia, and intermuscular septum type the boundaries of the lower limbs lateral compartment. Within this compartment runs the superficial fibular nerve, which is responsible because that plantar flexion and also eversion. The fibula"s posterior surface, deep fascia, and interosseous membrane form the boundaries of the lower limbs posterior compartment. The tibial nerve runs through this compartment and also is responsible for plantar and digit flexion. The fibula"s medial surface partially borders the lower limbs anterior compartment.


Many crucial muscles connect to the fibula i m sorry molds the fibular shaft right into its unique shape.

The biceps femoris tendon attaches to the fibular head.
The fibularis longus and fibularis brevis tendons attach to the lateral fibula.
The extensor digitorum longus and extensor hallucis longus tendons attach to the medial fibula.

Surgical Considerations

Fibula bone grafts are the gold standard in mandibular reconstructive surgeries. This is because removing the fibula from its anatomical ar will no greatly impact weight bearing, as that is mainly the function of the tibia. Additionally, the fibula is thin and long while maintaining an excellent vascularity. This enables for straightforward graft uptake and also osseointegration of dental implants. Once using the fibula together a graft, just the tower is used, and two ends of the fibula are left intact.<3>

Clinical Significance


There is strong support in recent literature to use the fibular shaft length to estimate infant bone age. This might be a much more accurate alternate to the existing methods of counting ossification centers or viewing hand/wrist or knee radiographs as method of estimating child bone age.

Fibular hemimelia or fibular hypoplasia-aplasia is the most frequent long bone deficiency. This causes partial or complete absence of the fibula. This is commonly diagnosed at birth once limb-length discrepancy and lack that digits are noted. Additionally, the lack of a lateral malleolus destabilizes the mortise in valgus. Thus, ankle blend is commonly needed.


The proximal end of the fibula has a slightly enlarged prominence which contains a facet the articulates with the lateral condyle that the tibia. Simply lateral and posterior to the fibular neck operation the typical fibular nerve (also well-known as the common peroneal nerve), i m sorry may become entrapped ~ trauma, direct injury or throughout its course near the fibular head. Typical fibular nerve entrapment is the most prevalent entrapment neuropathy the the lower extremity. Symptoms may include foot drop and also lateral limb sensory deficits, but given the absence of clean symptoms, misdiagnosis is common and may reason a delay in treatment.


The fibula can develop an avulsion fracture when there is a suddenly contraction of the biceps femoris muscle. This outcomes in a far-reaching pull on the fibula since the biceps femoris tendon attaches to the fibular head.

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The distal fibula proceeds to become the lateral malleolus. The lateral malleolus is significantly an ext evident than the medial malleolus and also can be palpated at the ankle. ~ above the lateral aspect of the ankle, the distal fibula is also prone come fracture (usually spiral), that deserve to occur during forced exterior rotation that the ankle. Another means of injury occurs throughout eversion of the foot (outward twisting the the foot) or direct trauma. The resulting fracture native an eversion injury is generally a transverse fracture that the fibula. A clinical decision-making tool called The Ottawa Ankle rules (OAR) can be offered in doubt lateral malleolus injuries. The OAR is helpful in lessening unnecessary radiographs and are a reliable tool to exclude fractures in kids over age 5.

Fibular fractures alone rarely reason compartment syndrome. However, when a tibial plateau fracture is present, over there is a greater likelihood that the fibular fracture will contribute to the compartment syndrome.    <4>