Incisura Fibularis

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Incisura Fibularis

Posterior aspect of the tibia showing the incisura fibularis (©PodiaPaedia)


Incisura Fibularis is the Latin term for the fibula notch. This is the hollow triangular-shaped area on the postero-lateral surface of the distal end of the tibia in which the fibula is lodged. According to Terminologia Anatomica, the preferred Latin name should be incisura fibularis tibiae.

It is a landmark that is used clinically in assessing syndesmotic stability following an injury, but due to the wide anatomical variability it is suggested that this assessment may not be accurate.

A systematic review by Prakash, (2016) reported that the anterior facet length (AFL) varied from 7 to 17.7 mm; the posterior facet length (PFL) varied from 9 to 20.6 mm; the incisura fibularis height (IFH) varied from 19 to 43.8 mm; and incisura fibularis length (IFL) varied from 10.1 to 36 mm. The depth of incisura fibularis varied considerably across studies with some reporting it to be predominantly deep (≥4 mm) and others reporting it to be shallow (<4 mm). The PFL, IFH, IFL dimensions were larger in males compared to females. No side-to-side differences were reported in the studies included in the systematic review.

More recently Yaka et al (2023) found that a more posterior (retroverted) fibular notch and a lower fibular notch angle seem to be associated with higher rates of anterior talofibular ligament rupture.

These anatomical variations of the incisura fibularis tibiae may have clinical implications. For example, a more shallow one may be less stable and predispose to recurrent ankle sprains or a syndesmotic injury. Yüce et al (2023) reported that differenced in posterior facet length and incisura width between those who had a posterior malleolus avulsion fracture or a syndesmotic ligament injury in ankle fractures.

The incisura fibularis is reported to ossify around 8 years in girls and 11 years in boys.

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