INTRODUCTION: Reduction of the distal fibula into the fibular notch (FN) poses a problem that has not been fully resolved, yet. A number of methods have been developed for the assessment of the position of the fibula in the FN, but none of them is ideal. A majority of authors assess the FN 1 cm above the tibiotalar joint space, without specifying the reason for the choice of this distance. None of the previous studies has addressed at what level the FN is the deepest. Our findings show that it is 4-5 mm above the ankle joint space and verification of this hypothesis has been the aim of this study. MATERIALS AND METHODS: Dry adult tibial bone specimens from the Pachner's collection of the Institute of Anatomy of 1st Faculty of Medicine, Charles University, Prague were used in the study. Height of the FN at its widest point, 3 mm and 10 mm above the articular surface of the distal tibia were measured in each specimen, as well as the depth of the FN at the deepest point, 3 mm and 10 mm above the articular surface of the distal tibia and the distance between the highest point of this surface and the deepest point of the notch. RESULTS: The mean length of the tibia was 350 mm; the mean height of the FN was 42.5 mm; the mean width of the FN at its widest point was 23.6 mm, at 3 mm above the tibiotalar joint space 22 mm, 10 mm above this articular surface of distal tibia (tibial plafond) 18.9 mm. The mean depth of the notch at 3 mm above the tibial plafond was 3.8 mm, at 10 mm above this surface 4.1 mm. The maximum mean depth of the notch was 4.5 mm, the distance from this point to the highest point of the tibial plafond was 5.3 mm. CONCLUSION: The deepest point of the FN lies 5 mm above the articular surface of the tibial plafond, with the mean value of the depth being 4.5 mm. This region is, therefore, ideal for assessment of the position of the distal fibula in the FN.

Department of Orthopedics 1st Faculty of Medicine Charles University and the Central Military Hospital Prague Czech Republic

Department of Surgery of 1st Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic

Institute of Anatomy 1st Faculty of Medicine Charles University Prague Czech Republic

000      

00000naa a2200000 a 4500

001      

bmc21012106

003      

CZ-PrNML

005      

20230516121343.0

007      

ta

008      

210420s2020 gw f 000 0|eng||

009      

AR

024    7_

$a 10.1007/s00276-020-02476-w $2 doi

035    __

$a (PubMed)32333090

040    __

$a ABA008 $b cze $d ABA008 $e AACR2

041    0_

$a eng

044    __

$a gw

100    1_

$a Fojtík, Petr $u Institute of Anatomy, 1st Faculty of Medicine, Charles University, Prague, Czech Republic $u Department of Orthopedics, 1st Faculty of Medicine, Charles University and the Central Military Hospital, Prague, Czech Republic $7 xx0301623

245    14

$a The fibular notch: an anatomical study / $c P. Fojtík, K. Kostlivý, J. Bartoníček, O. Naňka

520    9_

$a INTRODUCTION: Reduction of the distal fibula into the fibular notch (FN) poses a problem that has not been fully resolved, yet. A number of methods have been developed for the assessment of the position of the fibula in the FN, but none of them is ideal. A majority of authors assess the FN 1 cm above the tibiotalar joint space, without specifying the reason for the choice of this distance. None of the previous studies has addressed at what level the FN is the deepest. Our findings show that it is 4-5 mm above the ankle joint space and verification of this hypothesis has been the aim of this study. MATERIALS AND METHODS: Dry adult tibial bone specimens from the Pachner's collection of the Institute of Anatomy of 1st Faculty of Medicine, Charles University, Prague were used in the study. Height of the FN at its widest point, 3 mm and 10 mm above the articular surface of the distal tibia were measured in each specimen, as well as the depth of the FN at the deepest point, 3 mm and 10 mm above the articular surface of the distal tibia and the distance between the highest point of this surface and the deepest point of the notch. RESULTS: The mean length of the tibia was 350 mm; the mean height of the FN was 42.5 mm; the mean width of the FN at its widest point was 23.6 mm, at 3 mm above the tibiotalar joint space 22 mm, 10 mm above this articular surface of distal tibia (tibial plafond) 18.9 mm. The mean depth of the notch at 3 mm above the tibial plafond was 3.8 mm, at 10 mm above this surface 4.1 mm. The maximum mean depth of the notch was 4.5 mm, the distance from this point to the highest point of the tibial plafond was 5.3 mm. CONCLUSION: The deepest point of the FN lies 5 mm above the articular surface of the tibial plafond, with the mean value of the depth being 4.5 mm. This region is, therefore, ideal for assessment of the position of the distal fibula in the FN.

650    _2

$a dospělí $7 D000328

650    _2

$a poranění kotníku $x diagnóza $x chirurgie $7 D016512

650    _2

$a hlezenní kloub $x anatomie a histologie $7 D000843

650    _2

$a ženské pohlaví $7 D005260

650    _2

$a fibula $x anatomie a histologie $7 D005360

650    _2

$a lidé $7 D006801

650    _2

$a mužské pohlaví $7 D008297

650    _2

$a tibie $x anatomie a histologie $7 D013977

655    _2

$a časopisecké články $7 D016428

700    1_

$a Kostlivý, Karel $u Department of Surgery of 1st Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic

700    1_

$a Bartoníček, Jan $u Institute of Anatomy, 1st Faculty of Medicine, Charles University, Prague, Czech Republic $u Department of Orthopedics, 1st Faculty of Medicine, Charles University and the Central Military Hospital, Prague, Czech Republic

700    1_

$a Naňka, Ondřej $u Institute of Anatomy, 1st Faculty of Medicine, Charles University, Prague, Czech Republic. Ondrej.Nanka@lf1.cuni.cz

773    0_

$w MED00004462 $t Surgical and radiologic anatomy $x 1279-8517 $g Roč. 42, č. 10 (2020), s. 1161-1166

856    41

$u https://pubmed.ncbi.nlm.nih.gov/32333090 $y Pubmed

910    __

$a ABA008 $b sig $c sign $y p $z 0

990    __

$a 20210420 $b ABA008

991    __

$a 20230516121340 $b ABA008

999    __

$a ok $b bmc $g 1650479 $s 1132485

BAS    __

$a 3

BAS    __

$a PreBMC

BMC    __

$a 2020 $b 42 $c 10 $d 1161-1166 $e 20200425 $i 1279-8517 $m Surgical and radiologic anatomy $n Surg Radiol Anat $x MED00004462

GRA    __

$a AZV 16-28458A $p AZV-Ministry of Health of the Czech Republic

GRA    __

$a AZV 16-28458A $p AZV-Ministry of Health of The Czech Republic

GRA    __

$a AZV 16-28458A $p AZV- Ministry of Health of The Czech Republic

GRA    __

$a Specific University Research $p Charles University in Prague

GRA    __

$a NV16-28458A $p MZ0

LZP    __

$a Pubmed-20210420