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StatPearls . Sweetheart 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 reduced extremity that is positioned ~ above the lateral side of the tibia. The fibula is lot smaller and also thinner than the tibia. The is located just behind the tibial head in ~ the knee joint and then runs down the lateral element of the leg till it reaches the fishing eye joint. A ridge top top the medial surface ar of the fibula creates the interosseous border whereby the fibula is linked to the tibia via the interosseous membrane. This link forms a syndesmotic joint, definition it has actually very little mobility.<1><2><3>

The structure of the fibula can be damaged down right into the head, neck, shaft, and distal finish of the fibula. Together the head becomes narrow distally, the fibular neck is formed. The fibular obelisk lies distal come the neck and also has three surfaces, lateral, medial, and posterior. The shape of the fibular obelisk is figured out by the muscle attachments. Initially, it is a triangular shape and also distally becomes much more irregularly shaped. The distal finish of the fibula creates the lateral malleolus which articulates through the lateral talus, creating part of the lateral ankle. The posterior and lateral tibia type the posterior and also medial malleolus, respectively. 

Like the tibia, the fibula is ossified in three areas, in the middle and also at either finish of the epiphysis. Ossification the the fibula begins in the pillar at approximately the eighth main of gestation and also then extends to one of two people end. The process of ossification is finish by the second decade that life. Both end of the fibula stay cartilaginous.

Structure and Function

Unlike the tibia, the fibula is not a weight-bearing bone. Its main function is to incorporate with the tibia and carry out stability to the ankle joint. The distal finish of the fibula has several grooves because that ligament attachments which then stabilize and provide leverage during the fishing eye movements. The lateral (fibular) collateral ligament attaches to the lateral side of the fibular head. This ligament gives knee stability. However, the fibula itself has a little function in providing knee stability.

Blood Supply and Lymphatics

The blood it is provided to the fibula is native the fibular artery (also well-known as the peroneal artery) which has many tiny branches which supply the diaphysis. The epiphysis and the proximal fibular head are gave by branches the the anterior tibial artery. The periosteum likewise receives numerous tiny branches from the fibular artery and also supplies the remainder of the bone. That is necessary to understand 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 borders of the reduced limbs lateral compartment. In ~ this compartment runs the superficial fibular nerve, i m sorry is responsible because that plantar flexion and also eversion. The fibula"s posterior surface, deep fascia, and interosseous membrane form the boundaries of the reduced limbs posterior compartment. The tibial nerve runs through this compartment and also is responsible for plantar and also digit flexion. The fibula"s medial surface partially borders the lower limbs anterior compartment.


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

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

Surgical Considerations

Fibula bone grafts space the gold typical in mandibular reconstructive surgeries. This is because removing the fibula native its anatomical location will no greatly impact weight bearing, together that is largely the duty of the tibia. Additionally, the fibula is thin and long while maintaining great vascularity. This allows for easy graft uptake and also osseointegration of dental implants. When using the fibula together a graft, only the column is used, and two end of the fibula room left intact.<3>

Clinical Significance


There is strong support in recent literary works to use the fibular shaft length to estimate infant bone age. This may be a more accurate alternative to the existing methods of counting ossification centers or city hall hand/wrist or knee radiographs as means of estimating infant bone age.

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


The proximal end of the fibula has actually a slightly enlarged importance which includes a facet the articulates with the lateral condyle the the tibia. Just lateral and also posterior come the fibular neck operation the typical fibular nerve (also known as the usual peroneal nerve), which may end up being entrapped after trauma, straight injury or throughout its course near the fibular head. Usual fibular nerve entrapment is the many prevalent entrapment neuropathy that the lower extremity. Symptoms may include foot drop and also lateral limb sensory deficits, however given the absence of clear symptoms, misdiagnosis is common and also may reason a hold-up in treatment.


The fibula can develop an avulsion fracture as soon as there is a sudden contraction that the biceps femoris muscle. This results in a far-ranging pull ~ above the fibula due to the fact that 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 much more evident 보다 the medial malleolus and also can it is in palpated at the ankle. ~ above the lateral facet of the ankle, the distal fibula is additionally prone to fracture (usually spiral), that have the right to occur throughout forced exterior rotation that the ankle. Another means of injury occurs throughout eversion the the foot (outward twisting of the foot) or direct trauma. The resulting fracture indigenous an eversion injury is normally a transverse fracture that the fibula. A clinical decision-making tool dubbed The Ottawa Ankle rule (OAR) have the right to be provided in suspected lateral malleolus injuries. The OAR is valuable in lessening unnecessary radiographs and also are a reputable tool come exclude fractures in children over age 5.

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