The proximal tibiofibular articulation (also called superior tibiofibular joint) is an
arthrodial
A plane joint (arthrodial joint, gliding joint, plane articulation) is a synovial joint which, under physiological conditions, allows only gliding movement.
Plane joints permit sliding movements in the plane of articular surfaces. The opposed sur ...
joint
A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw- ...
fibula
The fibula or calf bone is a leg bone on the lateral side of the tibia, to which it is connected above and below. It is the smaller of the two bones and, in proportion to its length, the most slender of all the long bones. Its upper extremity i ...
.
The contiguous surfaces of the bones present flat, oval facets covered with cartilage and connected together by an
articular capsule
In anatomy, a joint capsule or articular capsule is an envelope surrounding a synovial joint.anterior and posterior ligaments.
When the term ''tibiofibular articulation'' is used without a modifier, it refers to the
proximal
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...
, not the distal (i.e., inferior) tibiofibular articulation.
Clinical significance
Injuries to the proximal tibiofibular joint are uncommon and usually associated with other injuries to the
lower leg
The human leg, in the general word sense, is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or gluteal region. However, the definition in human anatomy refers only to the section of the lower limb e ...
.
Dislocation
In materials science, a dislocation or Taylor's dislocation is a linear crystallographic defect or irregularity within a crystal structure that contains an abrupt change in the arrangement of atoms. The movement of dislocations allow atoms to s ...
s can be classified into the following five types:
* Anterolateral
dislocation
In materials science, a dislocation or Taylor's dislocation is a linear crystallographic defect or irregularity within a crystal structure that contains an abrupt change in the arrangement of atoms. The movement of dislocations allow atoms to s ...
(most common)
* Posteromedial dislocation
* Superior dislocation (uncommon, associated with shortened tibia fractures or severe ankle injuries)
* Inferior dislocation (rare, associated with lengthened tibia fractures or avulsion of the foot, usually extensive soft tissue injury and poor prognosis)
* Chronic instability (
subluxation
A subluxation is an incomplete or partial dislocation of a joint or organ.
According to the World Health Organization (WHO), a subluxation is a "significant structural displacement", and is therefore always visible on static imaging studies, suc ...
)
As there are often concomitant fractures and ligamentous injuries (e.g.,
ankle fracture
An ankle fracture is a break of one or more of the bones that make up the ankle joint. Symptoms may include pain, swelling, bruising, and an inability to walk on the injured leg. Complications may include an associated high ankle sprain, compartme ...
), anterolateral and posteromedial dislocations may be overlooked on first examination, with the potential to cause chronic instability. If the dislocation is recognized and treated properly, prognosis is typically good, although injury to the
common peroneal nerve
The common fibular nerve (also known as the common peroneal nerve, external popliteal nerve, or lateral popliteal nerve) is a nerve in the lower leg that provides sensation over the posterolateral part of the leg and the knee joint. It divides at ...
may occur. Inferior dislocations are exceptional as they usually only occur in avulsion (traumatic amputation) injuries. Subluxation may also occur in diseases with ligamentous laxity (e.g., Ehlers-Danlos Syndrome), muscle weakness (e.g., muscular dystrophy), or secondarily to degeneration (e.g., in
rheumatoid arthritis
Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are invol ...
).Sarma, A., Borgohain, B., & Saikia, B. (2015). Proximal tibiofibular joint: Rendezvous with a forgotten articulation. Indian Journal of Orthopaedics, 49(5), 489–495. http://doi.org/10.4103/0019-5413.164041