Joints - Tibiofibular

Question 1

What are the functions of the tibiofibular joints?

Answer 1

Stability and weightbearing, rather than movement.

Question 2

What type of joint is the proximal tibiofibular joint (PTJ)

Answer 2

Plane type synovial joint - bones glide over each other to create movement.

Question 3

PTJ - articulating surfaces?

Answer 3

Head of fibula and lateral condyle of tibia.

Question 4

PTJ - supporting structures?

Answer 4

Articular surfaces are lined with hyaline cartilage.

Joint capsule receives additional support from:

1) Anterior and posterior superior tibiofibular ligaments - spans between head of fibula and lateral condyle of tibia.
2) Lateral collateral ligament of the knee joint
3) Biceps femoris - inserts onto the head of fibula.

Question 5

PTJ - neurovascular supply?

Answer 5

Arterial supply

1) Inferior genicular arteries
2) Anterior tibial recurrent arteries

Innervation

1) Branches of the common fibular nerve
3) Nerve to popliteus (a branch of the tibial nerve)

Question 6

What type of joint is the distal tibiofibular joint (DTJ)?

Answer 6

A fibrous joint - joint surfaces are bound by tough, fibrous tissue.

Question 7

DTJ - articulating surfaces?

Answer 7

Fibula and fibular notch of the distal tibia.

Question 8

DTJ - supporting structures?

Answer 8

DTJ is supported by:

1) Interosseous membrane - a fibrous structure spanning between the length of the fibia and tibia.
2) Anterior and posterior inferior tibiofibular ligaments
3) Inferior transverse tibiofibular ligament - continuation of the posterior inferior tibiofibular ligament.

Doesn’t have a joint capsule.

Question 9

DTJ - neurovascular supply?

Answer 9

Arterial supply

1) Fibular artery
2) Anterior and posterior tibial arteries

Innervation

1) Deep fibular nerve
2) Tibial nerves

Question 10

Clinical relevance - dislocation of the PTJ

Answer 10

PTJ dislocation is a rare and often missed diagnosis, account for <1% of all knee injuries.

Mechanism of injury (typical) - falling onto an adducted and flexed knee. Also occurs as a result of high energy trauma.

Common clinical signs: inability to weight-bear, lateral knee pain and tenderness/ prominence of the fibular head.

Treated with closed reduction typically and restore its natural alignment.

Complication of PTJ dislocation include common fibular nerve injury as the nerve wraps around the neck of the fibula, and recurrent dislocation.