The tibia is the largest, strongest of the two lower leg bones. It forms the knee joint with the hip, the ankle joint with the fibula and the tarsus. Many powerful muscles that move the feet and lower legs attach to the tibia. Support, movement of the tibia is essential for many activities performed by the legs, including standing, walking, running, jumping, and supporting body weight.
The lower leg is in the lower leg, medial to the fibula, distal to the femur, and proximal to the talus of the foot. Its widest part is at the proximal end near the thigh, where it forms the distal end of the knee joint, then it tapers in length closer to the ankle joint ... [Read below]
[Top start] ... The proximal end is flat, with smooth, concave medial, lateral condyles forming the knee joint with the femur. Between the condyles are the attachment points of the meniscus and the anterior, as well as the posterior cruciate ligament of the knee joint. At the lower edge of the lateral condyle there is a small facet, where the tibia forms the proximal tibiofibular joint with the fibula. This joint is flat, allowing the tibial, peroneal to slide slightly past each other and adjust the position of the lower leg.
Just below the condyles, on the anterior surface of the tibia, is a large bony ridge that provides an attachment point for the patella through the patellar ligament. Shin extension involves contraction of the rectus femoris muscle, which pulls on the patella, which in turn pulls on the tibia. The tuberosity of the tibia and the anterior ridge, allow you to clearly determine the landmarks of the lower leg, as they are easily palpable through the skin.
Approaching the ankle joint, the shin bone expands slightly in the medial-lateral and anteroposterior planes. On the medial side, the tibia forms rounded bony processes known as the medial malleolus. The medial malleolus is formed on the medial side of the ankle with the talus of the foot; it can be easily identified by palpation of the skin in this area. On the lateral side of the lower leg there is a small depression that forms the distal tibiofibular joint with the fibula.
The structure of the tibia
The tibia is classified as a long bone due to its long, narrow shape. The long bones are hollow in the middle, with cancellous bone regions at each end and strong, compact bone enclosing their entire structure. The cancellous bone is made up of tiny columns known as trabeculae that strengthen the ends of the bones from external stress. The red bone marrow, which produces blood cells, is located in the cancellous bone openings between the trabeculae.
The hollow middle of the bone, known as the medullary cavity, is filled with fat-rich yellow bone marrow, which stores energy for the body. Surrounding the marrow cavity, cancellous bone, is a thick layer of compact bone that gives it most of its strength as well as mass. Compact bone is composed of cells surrounded by a matrix of solid mineral calcium and collagen protein, which is extremely strong and flexible to withstand stress.
Around the compact bone is a thin, fibrous layer known as the periosteum. The periosteum is made up of dense, fibrous connective tissue to which ligaments are attached that connect the tibia to the surrounding bones and tendons that attach muscles to bone. These joints prevent muscles and bones from separating from each other.
Finally, a thin layer of hyaline cartilage covers the ends of the tibia, where it forms the knee and ankle joints. The hyaline layer is extremely smooth and slightly flexible, providing a smooth surface for the joint to glide as well as cushioning to withstand impacts.
At birth, the lower leg is made up of two bones: a central trunk known as the diaphysis, and a thin lid just below the knee known as the proximal pineal gland. The thin layer of hyaline cartilage separating the two bones allows them to move slightly relative to each other. The distal end of the tibia is made up of hyaline cartilage at birth, but begins to ossify at about 2 years of age, forming the distal epiphysis. Throughout childhood, the diaphysis and the two pineal glands remain separated by a thin layer of hyaline cartilage known as the epiphyseal cartilage or growth plate. The cartilage in the epiphyseal plate grows throughout childhood, adolescence, and is gradually replaced by bone tissue. The result of this growth is the lengthening of the legs. In late adolescence, the diaphysis and pineal gland merge into one tibia.
The tibia is located in the lower leg. It is the longest and largest of its bones. There is nothing complicated in its structure: two articular ends and a body. The upper end takes part in the formation of the knee joint, and the lower end, together with the talus and fibula, form the ankle joint.
Anatomy
If you delve into the anatomy, it becomes clear that the proximal end of this bone forms the medial and lateral condyles, which are equipped with slightly concave articular areas. The articular surfaces of the condyles are separated by an eminence that has two tubercles. In addition, they are surrounded by a thickened edge. The anterior surface of the bone has a massive rough bulge. The posterolateral part of the lateral condyle has a small flat articular surface. At this point, an articulation occurs with the head of the fibula.
As a result, you can see that the tibia has a triangular shape:
- Front edge;
- medial edge;
- the lateral edge that faces the fibula.
There are three surfaces between these faces:
- back;
- medial;
- lateral.
Under the skin, the sharpest anterior edge and the medial surface are very well felt. The anatomy of the inferior distal end is based on the presence of the medial malleolus, which is a sturdy process located below on the medial side. Behind this ankle there is a flat bony groove - this is the mark from the passage of the tendon. The lower end of the bone has devices for connecting to the foot. The lateral edge of the distal end has a notch, which is the junction with the fibula.
The tibia has a simple but highly thought-out structure that allows a person to carry out the necessary movements. Injuries, cracks, fractures in this area bring great inconvenience, not to mention serious consequences.
Tibial injury
It is worth noting that fractures of the tibia are among the most common injuries to the long bones. Displaced injuries, cracks and various bruises can occur. This part of the human skeleton is subject to various bruises that occur as a result of road accidents and other situations. Consider the two main classifications of injuries in this area.
In addition, there are several more types of fractures that affect the tibia.
Treatment
If it is clear that an injury has occurred in the area of the tibia, first aid should be provided to the victim. Before arriving at the hospital, the patient is given anesthetic and the shin is immobilized using a splint or improvised means. An open pearl is immediately noticeable, so it is important to remove all foreign bodies and contamination around the wound and close it with a sterile dressing. If there is profuse bleeding, a tourniquet is applied to the thigh. It is impossible to immediately determine the presence of a crack, displacement and the type of injury. All necessary examinations are carried out in a hospital.
The tactics of inpatient treatment after first aid depends on the nature of the injury. Surgical or conservative intervention is performed. For stable fractures without displacement, although this is quite rare, a plaster cast is done. Most often, however, the tibia yields: the pin is passed through the heel bone, and the leg rests on the splint. For an adult patient, the average value of the first load is from 4 to 7 kg, but much depends on the weight, the type of fracture, and so on. The effectiveness of the procedure depends on how much the weight of the cargo is. The weight of the load can be decreased or increased.
If the treatment is conservative, the traction lasts a month. If signs of callus appear, the traction is removed, but a plaster cast is applied to the leg for 2.5 months. The patient must first use analgesics. Physiotherapy and LPF are indicated. After removing the plaster, rehabilitation measures are of great importance.
Surgical treatment is carried out after multiple fractures, when it is impossible to restore the position of the fragments conservatively. It also avoids post-traumatic contractures. How long does it take for the operation to be performed? Usually a week after the patient is admitted to the hospital, since during this time it is possible to conduct a full examination and reduce the swelling of the limb.
The tibia is an important part of the lower limb. Fractures, cracks, displacement, bruises - all this has a bad effect on human life, and in especially serious cases leads to serious consequences. That is why you need to be attentive to the treatment of these problems and to rehabilitation, on which the future life and performance of a person depends.
The fibula is represented by an elongated tubular formation. The bone is represented by the body, or diaphysis, and two vertices, called the epiphyses. The lower fragment, called the lateral malleolus, is involved in the creation of the ankle joint. The lateral ankle acts as a kind of stabilizing factor in the joint located between the lower leg and foot.
Anatomy and position relative to other bones
The musculoskeletal system (MSA) in adults is represented by active and passive parts. The active component includes muscles, ligamentous apparatus. A passive fragment is indicated by a skeleton made up of bones and their joints. In the body of an adult, this part is represented by 208 bones. In order to properly redistribute a person's body weight in the process of life, the inner part of the bones is hollow. With the help of this, the weight of the skeleton is less in comparison with the total mass, however, despite this, the structure of the bones is strong, which allows the body to function adequately to the supplied loads.
To appreciate the physiological significance of the tibia, it is necessary to understand their topography. The fibula is located in the lower part of the skeleton (leg area), between the thigh and the foot, in contact with the tibia. Above, the shin bones are limited by the knee joint, from below by the ankle. A small bone is connected to the foot through the lateral ankle through the ankle joint. Large ligaments are located between the tibia.
In accordance with the length in the tibia, 3 parts are distinguished: the diaphysis (body) and 2 pineal glands (upper, lower fragment). The body of the bone is bent backward and twisted along the axial direction. The diaphysis is represented by a prism and consists of three faces: medial, lateral and posterior. Each of the edges is separated by a ridge. The medial and lateral edges are separated by the anterior projection, the inner (medial projection) divides the medial and posterior sides of the bone, the posterior ridge is located between the posterior and lateral sides.
On the back of the MBC there is an opening for the exit of blood vessels and nerves. A special canal extends distally from this hole into the bone, communicating through the holes with canals in other areas of the skeleton. On the inner side, between the bones, there is a delimiting edge. The upper epiphysis, represented by the head, contacts the articular side with the tibia. The top is pointed. The head is connected to the shaft of the fibula through the neck.
One of the most important formations of the fibula is distinguished by the peculiarity of topography and interaction with the bones of the foot and lower leg through the lower pineal gland. The distal portion of the bone is often referred to as the lateral malleolus. This ankle is easily palpable through the skin when the foot is flexed forward.
On the inner side of the lower pineal gland is the articular side, which provides the connection of the talus and the lateral malleolus. Slightly higher in the fibula, there is a slight roughness that connects to the peroneal notch in the tibia. There is an ankle groove posteriorly on the fibula. The peroneal tendon passes through this depression.
Impact on functions in the musculoskeletal system
The leading function, which is performed by the fibula, laid down in the process of ontogenesis, is the provision of rotation in the ankle. Rotation in this case is a turn to the right or left of the lower leg and foot in relation to each other. Given the anatomical structure, location, under the influence of a strong traumatic aspect, the bone tissue is prone to fractures.
Usually, a fracture first appears in the tibia because it takes on the leading stress while walking. Massive injuries or strong local effects of a negative factor can cause damage to the tibia, often with rupture of soft tissues, and displacement of bone fragments. Fractures appear in various parts of the fibula. Most often noted in the lower pineal gland.
Tibia fracture options:
Fractures are usually combined with subluxation and dislocation of the foot, rupture of the distal syndesmosis between the tibia, and shortening of the bone. To understand that there was a fracture of the entire or a fragment of the fibula, it is necessary to note a number of characteristic symptoms, the main of which are pain at the site of the lesion, which increases with palpation and movements in the ankle or the application of a vertical load, edema.
The pain is noted constantly and intensifies when walking or standing. These symptoms usually occur after a leg injury or fracture. To restore bone function in full, it is necessary to consult a traumatologist as soon as possible.
Briefly about therapeutic measures and healing times
Treatment of fibula fractures is performed conservatively or surgically. First, they begin non-operative intervention. The conservative technique is based on the comparison of separated fragments of bone tissue and their subsequent retention. The primary point in the tactics of treatment, the traumatologist must carry out the reposition of the fragments, thereby excluding the further deployment of the MBC and subluxation or dislocation of the foot. Upon successful completion of the reduction, confirmed by the results of X-ray examination, the ankle is closed with a plaster mass or orthosis.
In a situation where the joining and fixation of the pieces of bone did not give the necessary results, a surgical intervention is prescribed, represented by a number of stages:
After the performed surgical intervention, the patient must go through a period of rehabilitation. The timing of the fusion of the fibula is individual, and in uncomplicated variants corresponds to 2-3 months. When multiple bone fractures were noted, as well as a history of burdening (somatic pathology in the stage of compensation and decompensation), the fracture in the fibula continues to heal for six months. In order to accelerate the overgrowth of the fracture, to recreate the functions, the patient is prescribed therapeutic exercises and massage. Not in the acute period, treatment is supplemented with physiotherapy intervention.
Most people who are faced with fractures of the bones of the lower extremities, especially the tibia, which plays an important role in the development of the ankle joint, are worried about the further consequences and forecasts of qualified specialists.
The result of treatment depends not only on the correct comparison and fixation of the fragments. It is extremely important for the patient to strictly adhere to all the doctor's recommendations. It is especially necessary to protect the fracture area from unnecessary physical activity during the rehabilitation period and after. The sooner from the moment of the leg injury the patient seeks qualified help, the greater the likelihood of successful treatment and complete rehabilitation.
Sometimes after bone fracture, conservative or surgical interventions, the following consequences may occur:
To prevent movement problems after a bone or ankle fracture, it is necessary to take care of your legs. If an injury does occur, it is necessary to urgently consult a traumatologist.
After a fracture, the site of the lesion should be protected throughout life and not subjected to further great physical exertion.
What are the functions of the tibia and tibia? Where are each of them located? How do they connect?
The first (tibia) bone is located medially.
The severity of the entire body is transferred to the support area along the vertical (mechanical) axis of the entire leg. The tibia is connected to the thigh bone through the knee joint. The axis of the lower limb runs vertically through the center to the center. The tibia carries the weight of the whole body, which determines its greater (in comparison with small) thickness.
Sometimes there is a deviation to the lateral or medial side, which entails a change in the angle between the lower leg and the thigh. With pronounced deviations, there is an "x-shaped" or "o-shaped" shape of the legs.
The epiphysis (proximal edge) forms two (lateral and medial) condyle. On the side facing the thigh, they have weakly concave articular platforms that perform a connecting function. The division of the articular surfaces of the condyles is carried out by an eminence with two tubercles. There is one small fossa at the anterior and posterior ends of the eminence. The surface of the joints is surrounded by a thickened edge (trace from the attachment of the joint capsule). The anterior surface of the bone has a very massive rough bulge - the site of attachment of the tendon (in the form of the patellar ligament) of the quadriceps muscle. The posterolateral part of the lateral condyle includes a small flat surface (the site of attachment of the peroneal bone head). The body consists of the anterior, medial and lateral faces, between which the posterior, medial and lateral surfaces are located. In this case, the sharpest (front) edge and the medial surface are clearly felt through the skin. On the medial side of the lower distal end (pineal gland) there is a strong process (medial malleolus), behind which is a flat groove. At the lateral end of the distal edge is the notch where the tibia and the tibia meet. The foot skeleton abutments are located on the lower edge.
The second (small, thin and long, with thickened ends) tibia is located laterally in the tibia. The proximal (upper) pineal gland forms the head. Through the flat, roundish surface of the joint, it adjoins the literal tibial bony condyle. The top of the head is a protrusion located somewhat laterally and posterior to this surface. The triangular shape of the bone body is somewhat twisted along the entire longitudinal axis. The distal (lower) pineal gland is thickened and forms a lateral (with a smooth surface of the joint) ankle.
Fractures of the condyles (intra-articular damage)
As a rule, they occur when the lower leg deviates inward or outward, or at the time of falling on straight legs. Distinguish between a fracture of the internal and external condyle. Intra-articular damage can be accompanied by damage to the ligamentous apparatus in the intercondylar eminence, peroneal bone head, etc.
Fractures are accompanied by an increase in the volume of the joint, while the limb is slightly bent. There is a deviation of the lower leg outward (with damage to the external condyle) or inward (with damage to the internal condyle). In the area of the condyles, the transverse size is significantly increased. There is also a lack of active movements in the joint, including the inability to raise the leg in a straightened state. With passive movements, a sharp pain occurs. In some cases, damage to the external condyle is accompanied by damage to the neck or peroneal bone head. In this case, nerve damage can be observed, which is revealed by a violation of the sensitivity and motor function of the foot.
Tibia, long. It distinguishes between a body and two pineal glands - upper and lower.
The body of the tibia, corpus tibiae, is triangular in shape. It has three edges: anterior, interosseous (external) and medial - and three surfaces: medial, lateral and posterior.
Tibia video
The front edge, margo anterior, the bone is pointed and looks like a ridge. In the upper part of the bone, it passes into the tuberosity of the tibia, tuberositas tibiae. The interosseous edge, margo interosseus, is pointed in the form of a comb and directed towards the corresponding edge of the fibula. The medial margin, margo medialis, is rounded. Medial surface, facies medialis. or anteroposterior, somewhat convex. She and the anterior edge of the tibial body, limiting it in front, are well felt through the skin.
The lateral surface, facies lateralis, or antero-outer, slightly concave.
The back surface, facies posterior, is flat. It distinguishes the line of the soleus muscle, linea m. solei, which runs from the lateral condyle downward and medially. Below it is a feeding hole that leads to a distally directed feeding channel.
Upper, proximal, epiphysis of the tibia, epiphysis proximalis tibiae, expanded. Its lateral sections are the medial condyle, condylus medialis, and the lateral condyle, condylus lateralis. On the outer surface of the lateral condyle there is a flat peroneal articular surface, facies articularis fibularis. On the proximal surface of the proximal epiphysis of the bone in the middle section, there is an intercondylar eminence, eminentia intercondylaris. Two tubercles are distinguished in it: the internal medial intercondylar tubercle, tuberculum intercondylare mediale, behind which is the posterior intercondylar field, the area intercondylaris posterior, and the external lateral intercondylar tubercle, tuberculum intercondylare laterale. In front of him is the anterior intercondylar field, area intercondylaris anterior; both margins serve as an attachment point for the cruciate ligaments of the knee. On the sides of the intercondylar eminence, the upper articular surface, facies articularis superior, carries concave articular surfaces, respectively, to each condyle - medial and lateral. The latter are circumferentially limited by the edge of the tibia.
Lower, distal, epiphysis of the tibia, epiphysis distalis tibiae, quadrangular. On the lateral surface of it there is a peroneal notch, incisura fibularis, to which the lower epiphysis of the fibular bone is adjacent. The ankle groove, sulcus malleolaris, runs along the back surface. Anterior to this groove, the medial edge of the lower epiphysis of the tibia passes into a downward process - the medial malleolus, malleolus medialis, which is easily felt through the skin. The lateral surface of the ankle is occupied by the articular surface of the ankle, facies articularis malleoli. The latter passes to the lower surface of the bone, where it continues into the concave lower articular surface of the tibia, facies articularis inferior tibiae.
