Evaluation of tibiofibular motion under load conditions by computed tomography

Abstract

Evaluation of tibiofibular motion in vivo has been possible only by invasive methods. A new noninvasive method has been developed that uses computed tomography (CT). A special device was constructed for use on the CT table to study fibular motion with load placed across the ankle. From dorsal to plantar flexion the fibula moved 1.1 +/- 0.4 mm medially with an accompanying nonsignificant ventral shift and medial rotation. Application of load across the ankle did not significantly alter these findings. In a subgroup of predominantly females, plantar flexion of the ankle provoked a dorsal fibular motion of 0.7 +/- 0.8 mm. In this subgroup application of load across the ankle reduced the medial and dorsal motion during the accompanying plantar flexion. The mechanism of these different movements can be deduced from the morphology of the ankle joint and its ligamentous and muscular guidance mechanism. The variable axis of joint movement and the insertion of the lateral ligament forced the fibula anterior in plantar flexion. When external talar rotation is present, the normal fibular motion is prevented unless load is applied across the ankle. This new investigative procedure permits study of the sequelae of traumatic and iatrogenic injuries to the fibula.

Salvage Technique for Treatment of Periplafond Tibial Fractures: The Modified Fibula-Pro-Tibia Procedure

“…2b 2c 2d ability. 8,9 This is consistent with the results in our patients, who show no functional loss from fusion of the distal tibia and fibula.…”

Axial Rotation and Mediolateral Translation of the Fibula During Passive Plantarflexion

“…Many studies have been performed to investigate the movement of the fibula as a consequence of ankle motion. 1-3,6-9,10,11,13,17-21 The relationship between the tibia and fibula during various movements of the ankle has always been studied as translation and rotation of the fibula with respect to the tibia. While some authors have demonstrated an anterior- posterior translation of the fibula during plantar/dorsiflexion of the ankle, others have not been able to observe it in a significant way.…”

“…Some investigations have reported more than 2 mm of ankle mortise widening, while others have not been able to demonstrate any lateral displacement. 1,2,7,10,18 In this study, lateral displacement of the proximal fibula was in the range of −0.3 to 3 mm for 30 degrees dorsiflexion and in the range of 0.6 to −2 mm for 30 degrees plantarflexion, while the distal fibula had a lateral displacement in the range 2.2 to −0.6 mm for 30 degrees dorsiflexion and 1.2 to −2.5 mm for 30 degrees plantarflexion (negative values indicate medial translation). These values reveal that the amount of lateral displacement of the fibula varied considerably among the specimens tested.…”

Tibiofibular Synostosis Stress Fracture: A Case Report

“…1,6,7,13 The syndesmotic ligaments are elastic and are an important component of stress transference; the interosseus membrane normally transmits 30 -50% of body weight to the fibula. 8,11 The tridimensional motion of the fibula is also well established, 4 with the fibula moving distally during the initiation of stance phase and push-off. This motion deepens the mortise and also pulls the fibula medially to further stabilize the talus.…”