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Tibiofibular Joints

Tibiofibular Joint•Introduction

•Relatively immobile structure•Joins the two shin bones; the tibia (outer)

and the fibula (inner)•Separated into two parts•The Superior tibiofibular (Proximal or upper

joint) just below the knee•The Inferior tibiofibular (Distal or ankle

joint) which lies above the ankle joint

Tibiofibular Joints•Introduction

•Function is to limit the movement between the two shin bones caused in particular by twisting movements of the leg

•Composed of strong ligamentous bands that pass diagonally between the tibia and fibula bones

Tibiofibular Joints•Two in number,• present between the opposing surfaces of

the extremities of Tibia and Fibula•Fibula forms a lateral support for the

ankle joint and is not required to have any independent movement

•Provide a certain amount of elasticity•Are highly gliding

Tibiofibular Joints

Tibiofibular Joints•Superior Tibiofibular Joint•Formed between the small oval facet on

the inner surface on the head of the fibula•And the facet on the posterior part of the

external tuberosity of the tibia•Surrounded by a capsule•And several strengthening ligaments

Superior Tibiofibular Joints

Inferior Tibiofibular Joints•Synonyms•Distal Tibiofibular Joint•Ankle syndesmoses

•Proximal Component•Concave facet of the distal tibia

•Distal Component•Convex component of the distal fibula

Inferior Tibiofibular Joints

Inferior Tibiofibular Joint•Type of Joint•Syndesmoses rather than synovial joint

•Motion•Anterolateral glide with dorsiflexion•Posteromedial glide with ankle

planterflexion

Tibiofibular Joints•Anterior Inferior Tibiofibular

Ligament

•A strong band of fibres attached to the front of the lower end of the tibia and outer malleolus

•Posterior Anterior Tibiofibular Ligament

A strong band of fibres attached to the lower end of the tibia on the outer mallealus on the posterior aspect of bones

Tibiofibular Joints•Tranverse Inferior Tibiofibular

Ligament

•Attached to the posterior inferior border of the tibia and the pit or fossa on the posterior part of the inner surface of the external malleolus

Tibiofibular Joints• Interosseus Membrane

• Attached to the interosseus borders• May be considered an accessory ligament to

these joints• Joints the inferio tibular joints below• May join the inferio-tibular joint above• But there is always an opening in the upper part

for the anterior tibial vessels• Fibers are mainly directed downwards and

outwards

Tibiofibular Joints•Interosseus Membrane

•Connects the opposing surfaces•Is continuous above the interosseus

membrane•Attached in front and behind to the

ligaments

Tibiofibular Joints•Synovial Membrane

•Lines the joint cavity•Is continuous with that of ankle joint

Clinical Significance •Proximal Tibiofibular Joints Ganglion

Cysts

•Are rare entities that can cause disability•Excision remains the main surgical

treatment•Cyst recurrance has been a problem•Proximal tibiofibular joint arthrodesis

appears to be a more effective surgical option after a recurrance

Clinical Significance•Proximal Tibiofibular Joint

Dislocation

•Occurs most commonly when the athlete sustains an impact or falls with their knee in a fully flexed position with their foot pointing inwards (inversion) and downwards

•This puts added strain on the muscles which connect fibula to the foot and toes such as the peroneal muscles

Clinical Significance•Proximal Tibiofibular Joint

Dislocation

•In this position the tibia is pulled forwards

•And if the force is sufficient it may cause the joint to become dislocated

•This injury should be treated quite seriously as it may sometimes be associated with injury to the peroneal nerve

Inferior Tibiofibular Joint (AP)

Inferior Tibiofibular Joint (PA)