The axial compression load resulting from a fall from a significant height can cause depression, splitting, or even comminuted fractures of the tibial plateau. The severity of the fracture is associated with the magnitude and duration of the force. The most common mechanism of injury involves axial loading and/or valgus or varus force, such as from a fall or automobile accident. The head of fibula is the site for the insertion of the lateral collateral ligament and the tendon of the biceps femoris muscle. The fibula acts as a splint, or crutch, for the tibia but does not bear nearly as much weight of the body as the tibia. A small prominence, located on the anterior aspect of the lateral condyle of the tibia, is known as the Gerdy tubercle, where the iliotibial band inserts. Between the patellar ligament and the tibia lies the deep infrapatellar bursa. The tibial attachment of the patellar ligament is 2.5–3 cm distal to the joint line on the anterior tibial crest.
On the anterior side of the knee, running between the apex of the patella and tibial tuberosity, is the patellar ligament. The region of the tibial spines is extra-articular therefore, there is no coverage by articular cartilage ( Plate 5.3).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 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°. 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. 5.5 Segment distribution of 1430 tibia/fibula fractures in children. Table 5.1 Sex distribution of 11555 patients with tibia/fibula fracturesįig. fracture of the tibia shaft is the most common tibia/fibula fracture.The most affected male age group is 31–40 years, while females aged 41–50 years have the highest risk the high-risk age group is 31–40 years.more left-side than right-side injuries.Among these 11555 patients, 1421 were children with 1430 fractures, and 10134 were adults with 10234 fractures.Įpidemiologic features of tibia/fibula fractures are as follows: All cases were reviewed and statistically studied the fractures accounted for 19.17% of all patients with fractures and 17.87% of all types of fractures, respectively. The continuity of the fibula is very important in maintaining the stability of the ankle mortise ( Plate 5.1).Ĭlinical Epidemiologic Features of Tibia/Fibula FracturesĪ total of 11555 patients with 11664 fractures of the tibia/fibula were treated at our trauma center over a 5-year period from 2003 to 2007. 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. Tibia 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. 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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