Fibula & patella

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1. SM BADAR HAYAT TUTOR DEPARTMENT OF ANATOMY NMCH, JAMUHAR FIBULA & PATELLA

2. CONTENTS Introduction Anatomical position Side determination Parts Attachments Ossification Clinical anatomy

3. Introduction It is the lateral bone of leg and is long but very slender. Its homologous with the ulna. It takes no part in transmission of body weight. In latin, the term fibula means “pin”.

4. Anatomical position Bone is vertically placed.

5. Side determination Head lies above. Lower end is expanded antero-posteriorly but flat from side to side. Medial surface of the lower end has a triangular facet at its anterior part while the malleolar fossa lies below and behind the facet.

6. Parts Upper end (head) Shaft Lower end (lateral malleolus)

7. Upper end It is expanded all around and overhangs the shaft on the posterior and lateral aspects. It bears a circular facet on its upper surfaces which articulates with fibular facet on the lateral condyle of tibia forming superior tibio- fibular joint.

8. Apex of head (styloid process): it is a small blunt process, projecting upwards from postero-lateral aspect of head . Fibular collateral ligament of knee joint is attached just in front of the apex Neck: the slightly constricted part just below the head It is related on its postero-lateral aspect to common peroneal nerve.

9. shaft It possesses 3 BORDER ANTERIOR INTEROSSEOUS POSTERIOR 3 SURFACES LATERAL MEDIAL POSTERIOR

10. Borders Anterior : Extends from anterior aspect of the upper end to the apex of an elongated triangular area which is continuous below with the lateral surface of lateral malleolus. Below, it divides into two lines between which is the triangular area. To its upper 3/4 th is attaced anterior intermuscular septum of the leg.

11. Interosseous Lies on medial side of anterior border; in upper 2/3 rd the two borders lies very close to each other. It divides into two limbs at the lower fourth to enclose a rough triangular area.

12. Posterior Begins above from lower part of the posterior aspect of the head and below it is continuous with medial border of the groove on the back of lateral malleolus. Its upper part is rounded and not easily recognisable. Gives attachment to posterior intermuscular septum of leg in its upper 3/4 th part.

13. Surfaces Lateral ( peroneal ) : Lies between anterior and posterior borders. Its lower fourth becomes continuous with the groove on the back of lateral malleolus .

14. Medial (extensor) Lies between anterior and interosseous borders. It is very narrow in its upper part but is wider below.

15. Posterior Lies between interosseous and posterior borders and is the widest of all surfaces. Its faces backwards and medially. Medial crest- It is prominent vertical ridge dividing upper 2/3 rd of this surface into two areas. It gives attachment to deep intermuscular septum. Lower part of this surface faces medially and fits into the fibular notch of tibia. It gives attachment to interosseous tibio -fibular ligament.

16. A nutrient foramen lies near the middle of this surface between the medial crest and interosseous border. It is directed downwards, therefore upper end of the bone is the growing end. The nutrient artery is a branch of peroneal artery. Anterior & posterior borders of the rough triangular area give attachment to anterior & posterior tibiofibular ligaments.

17. Lower end (lateral malleolus ) It projects downwards to a lower level than the medial malleolus and possesses: Lateral surface : It is subcutaneous, smooth and convex. It forms a bony projection on lateral aspect of ankle joint . 2. Posterior surface: It has a broad groove which lodges tendons of peroneus longus & brevis . Lateral border of the groove gives attachment to superior peroneal retinaculum .

18. 3. Anterior surface: It is continuous below with the inferior border and gives attachment to anterior talo -fibular ligament. 4. Medial surface: It has a triangular facet in front, with its apex downwards, which articulates with lateral surface of talus in forming ankle joint. Malleolar fossa : It is a rough depressed area behind the facet. It bears many vascular foramina. Upper part of the malleolar fossa gives attachment to posterior tibio -fibular ligament. 5. Inferior border: It has a small notch in front which gives attachment to calcaneo -fibular ligament.