5.13).īetween the lateral and medial condyles, on the proximal anterior surface of the tibia, lies a very large triangular prominence known as the tibial tuberosity. The region of the tibial spines is extra-articular therefore, there is no coverage by articular cartilage ( ▶ Fig. The two tibial plateaus are separated by the intercondyloid eminence, with its prominent medial and lateral tubercles, so-called tibial spines, where the anterior and posterior cruciate ligaments attach. The outer portion of each plateau is covered by a semilunar fibrocartilaginous meniscus. The lateral plateau is smaller and higher than the medial plateau thus, it decentralizes the shear load, which makes the lateral plateau more prone to fractures than the medial plateau. As a result, knee fractures often occur at the tibial plateau. The bone comprising the tibial plateau is cancellous, as opposed to the thicker cortical bone of the tibial shaft. The tibial plateau is not perpendicular to the longitudinal axis of the tibial shaft, but slopes posteriorly at ~10 degrees. These plateaus articulate with the medial and lateral femoral condyles, respectively. The medial and lateral tibial plateaus are the articular surfaces of the medial and lateral tibial condyles. The upper end of the tibia is large, and expands laterally into two ridges, the medial and lateral condyles. 5.12 Segment distribution of 8,264 tibial/fibular fractures in children. Table 5.6 Sex distribution of 66,758 patients with tibial/fibular fracturesįig. The malleolar injury is the most common tibial/fibular fracture.The most affected male age group is 41–45 years, while females aged 56–60 years have the highest risk. The high-risk age group is 41–45 years.More left-side than right-side injuries.Among these 66,758 patients, 8,144 were children with 8,264 fractures, and 58,614 were adults with 60,614 fractures.Įpidemiologic features of tibial/fibular fractures are as follows: All cases were reviewed and statistically studied the fractures accounted for 16.09% of all patients with fractures and 15.95% of all types of fractures, respectively. 5.7 Causal mechanisms distribution of 417 patients with tibial/fibular fractures in the China National Fracture Study (CNFS).Ĭlinical Epidemiologic Features of Tibial/Fibular FracturesĪ total of 66,758 patients with 68,878 fractures of the tibia/fibula were treated in 83 hospitals of China over a 2-year period from 2010 to 2011. Malleolar fractures are the exception to the rule of dividing each long bone into three bony segments based on their anatomic characteristics: they are segment 44 of the tibial bone ( ▶ Fig. 5.1).ĪO Classification and Coding System of Tibial/Fibular Fracturesīased on AO classification, the tibia and fibula can be considered as one unit, with the coding number “ 4.” According to the “Heim’s Square” method, the anatomic assignment of the proximal, shaft, and distal portions are the numbers 41, 42, and 43, respectively. The continuity of the fibula is very important in maintaining the stability of the ankle mortise ( ▶ Fig. The medial malleolus of the tibia and the distal end of the fibula, along with the talar articulations, form the ankle mortise. The fibular head and distal third of the fibula are just beneath the skin’s surface, with the remaining parts attached by muscles and ligaments. ![]() The fibula is situated on the lateral side of the tibia, to which it provides a small amount of support. ![]() Tibial fractures are most often found at the junction of the middle and lower thirds of the bone, where tibial dimensions change. The anterior border begins above at the tuberosity and ends below at the anterior margin of the medial malleolus. It is sinuous and prominent in its upper two-thirds, but smooth and recessed below. The body of the tibia has three borders and three surfaces. The medial plateau possesses higher mechanical strength and is better suited to withstand compression than the lateral plateau. Both plateaus slope posteriorly approximately by 10 degrees. The proximal end of the tibia extends laterally to form the medial and lateral tibial plateaus that articulate with the femoral condyles. The tibia is a large weight-bearing bone, located on the anterior and medial side of the leg.
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