Radiographic Assessment of Fibular Length Variance: The Case for “Fibula Minus”

Vinod Panchbhavi, Barkha N. Gurbani, Candace Bailey Mason, Wayne Fischer

Research output: Contribution to journalArticle

Abstract

Given the high prevalence of ankle fractures and morbidity of malalignment after fixation, an appropriate anatomic relationship between the distal fibula and adjacent tibia and talus is important. The tip of the lateral malleolus of the fibula has often been described to be at the level of the lateral talar process. However, no studies to date have examined the relationship of the distal fibular tip to the lateral process of the talus. We assessed 66 weightbearing mortise radiographs for variability of the distal fibular tip in relation to the lateral process of the talus. The subjects were all skeletally mature, with a mean age of 45.3 ± 14.6 years. We used a paired t test with a null hypothesis that the true mean difference in the distance from the distal fibula to the lateral process was equal to 0. The mean distance of the distal tip of the fibula was 0.257 ± 0.127 cm proximal to the tip of the lateral process of the talus. The 95% confidence interval was 0.226 to 0.288. Of the 66 subjects, 65 had the distal tip of the fibula proximal to the lateral process of the talus, corresponding to a negative fibular variance. In the remaining subject, the distal tip of the fibula was at the same level of the tip as the lateral process of the talus. The distal tip of the fibula is most commonly not at the level of the talus lateral process, as often described in published reports. Instead, it has a variance analogous to the relationship between the lengths of the ulna compared with the radius. The distal tip of the fibula in our study was more often proximal to the tip of the lateral process of the talus and can be described as a negative fibular variance, or “fibula minus.”

Original languageEnglish (US)
Pages (from-to)91-94
Number of pages4
JournalJournal of Foot and Ankle Surgery
Volume57
Issue number1
DOIs
StatePublished - Jan 1 2018

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Keywords

  • ankle
  • ankle fracture
  • ankle joint
  • ankle mortise
  • fibula
  • fibular length
  • fibular plating
  • open reduction and internal fixation of ankle fracture
  • tip of the fibula

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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