Where is the tibia? Tibia: where it is located, structure and functions The tibia is located in relation to the fibula

The tibia is located in the lower leg. It is its longest and largest bone. 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, forms the ankle joint.

Anatomy

If we delve deeper 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 platforms. The articular surfaces of the condyles are separated by an eminence having two tubercles. In addition, they are surrounded by a thickened edge. The anterior surface of the bone has a massive, rough convexity. The posterolateral portion of the lateral condyle has a small, flat articular surface. At this point, 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.

Between these faces there are three surfaces:

• back;
• medial;
• lateral.

The sharpest, anterior edge, and the medial surface can be very clearly felt under the skin. The anatomy of the lower distal end is based on the presence of the medial malleolus, a robust process located inferiorly on the medial side. Behind this ankle there is a flat bony groove - this is the trace of the passage of the tendon. The lower end of the bone has adaptations for connections with 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 very thoughtful structure that allows a person to carry out the necessary movements. Injuries, cracks, and fractures in this area bring great inconvenience, not to mention serious consequences.

Tibia injuries

It is worth noting that tibial fractures are one of the most common injuries of tubular long bones. Displacement damage, cracks and various bruises may occur. This part of the human skeleton is subject to various bruises that occur as a result of accidents and other situations. Let's consider two main classifications of injuries in this area.

In addition, there are several other types of fractures to which the tibia is susceptible.

Treatment

If it is clear that an injury has occurred in the area of ​​the tibia, the victim must be given first aid. Before arriving at the hospital, the patient is given pain medication and the lower leg 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 from around the wound and cover it with a sterile bandage. If heavy bleeding occurs, a tourniquet is applied to the thigh. It is impossible to immediately determine the presence of a crack, displacement and type of injury. All necessary examinations are carried out in the hospital.

The tactics of inpatient treatment after first aid depends on the nature of the injury. Surgical or conservative intervention is performed. For stable, non-displaced fractures, although this is quite rare, a plaster cast is done. However, most often the tibia gives way: a pin is passed through the heel bone, and the leg is placed on a splint. For an adult patient, the average first load is from 4 to 7 kg, but much depends on weight, type of fracture, and so on. The effectiveness of the procedure depends on the mass of the cargo. The weight of the load can be reduced or increased.

If treatment is conservative, traction lasts for a month. If signs of callus appear, the traction is removed, but a cast is applied to the leg for 2.5 months. Initially, the patient should use analgesics. Physiotherapy and LVF are indicated. After the cast is removed, rehabilitation measures are of great importance.

Surgical treatment is carried out after comminuted fractures, when it is impossible to restore the position of the fragments using a conservative method. It also helps avoid post-traumatic contractures. How long does it take to do the surgery? Usually a week after the patient is admitted to the hospital, since during this time a full examination can be carried out and swelling of the limb can be reduced.

The tibia is an important part of the lower limb. Fractures, cracks, displacement, bruises - all this has a bad effect on a person’s 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 a person’s future life and performance depend.

The tibia is one of the key bones in the human body. It is extremely large and located medially compared to the tibia bone. In its upper part it connects to the femur. Thus, the knee joint is ultimately formed. In the lower part it is adjacent to the talus.

Body of the tibia

The tibia is a regular trihedron with three distinct edges.

The first edge is the front. It can be felt through the skin and palpated if desired. In its upper part there is a characteristic tuberosity. It is at this point that the quadriceps femoris muscle joins the tibialis.

The second edge is interosseous. It is slightly turned towards the fibula. At the same time it is very sharp.

The last, third, medial edge is also called the middle edge by doctors. It has a characteristic round shape.

Structure of the tibia

At its end, the tibia forms a pair of thickenings that serve for muscle attachment. In anatomy they are called condyles. There are two of them in the tibia - lateral and medial.

On the side that is closer to the human thigh, the condyles are equipped with slightly concave platforms, which are necessary for connection with the same condyles of the femur. The articular surfaces of the condyles are separated by a peculiar eminence, which has two tubercles. They are needed for reliable attachment of articular ligaments.

Injuries to the posterior edge of the tibia

The posterior edge of the tibia is extremely susceptible to fractures and damage. Injuries of this kind occur in a third of all victims of an ankle fracture.

Most often, according to the experience of traumatologists, a bone fragment is located in the back, possibly on the lateral side of the surface. The connection of bone fragments after a fracture for their better fusion in the case of tibial fractures is carried out only when the size of the fragment does not exceed a quarter of the entire surface of the joint.

Doctors distinguish several types of injuries to the posterior lateral edge of the tibia. Firstly, if there is a fragment of sufficient size, they speak of a contour fracture of the posterior ligament.

Secondly, the state of the fragments inside the joint itself.

Thirdly, if during the fracture there was an indentation of the surface of the tibia itself, then most often it is not possible to make an accurate diagnosis using only one initial x-ray. These are the most complex cases that require detailed and scrupulous study. Often, as a result of indentation, obstacles are formed, due to which it is not possible to quickly and effectively set the bone.

Right tibia

For clarity, let’s look at what the tibia is. The right one, when examined in detail, consists of 9 components.

It is based on the intercondylar eminence. To the right and slightly below it is the medial condyle, and even lower and in the center is the tibial tuberosity.

An important component of the structure is the interosseous edge, under which is the lateral surface, as well as the anterior edge, under which the medial surface is located.

The tibia ends at the medial malleolus. Anatomy today has carefully studied all the details of the structure of the human body, which today greatly simplifies the process of diagnosis and treatment.

Another component that cannot be ignored is the lateral condyle. It is located on the upper left side of the tibia.

Tibia by section

When considering the sections of the tibia, the main attention should be paid to the proximal section. It includes the upper part of the bone, which is directly involved in the formation of the knee joint. This section consists of two condyles. One is external, the second is internal, as well as the metaphysis. If during the injury the fracture line affected the articular surface of the tibia, then traumatologists call it articular.

Fractures of this part of the tibia can be minor (they are also called low-energy), for example, caused by a fall from a small height. And also more complex or high-energy, for example, with a strong mechanical blow to the knee area - during a football match or a collision with a car.

The second cases are more dangerous, since such injuries are likely to result in a large number of bone fragments. In any case, a fracture of this bone clearly belongs to the category of serious injuries and requires professional and qualified treatment. Most often, it is impossible to do without surgery to fuse broken bones and displace the resulting fragments. In this case, the tibia is secured with screws, and sometimes plates are added to them.

If it is definitely established that the fracture is intra-articular, then it is very important in this case to thoroughly restore the damaged surface, eliminating the displacement of bone fragments.

Otherwise, this is fraught with complications, the most common being post-traumatic osteoarthritis of the knee joints.

Intercondylar eminence

Another serious injury occurs when the intercondylar eminence of the tibia is affected. Such injuries are extremely painful and unpleasant. Most often they occur under the influence of indirect mechanical trauma. For example, when the impact is from behind or in front of the proximal part of the tibia, which is in a bent position. As a result, the cruciate ligaments are stretched to their limit and the bone is torn off. Another cause of such fractures is excessive abduction or hyperextension.

The first signs of just such damage are sharp pain and swelling in the area of ​​the knee joint. As a rule, the cause is an injury. Often such injuries occur in athletes from contact sports. The patient cannot fully straighten the leg; most have a drawer symptom. True, it cannot always be installed due to spasm of the muscles that surround the knee joint. In order to make an accurate diagnosis, an x-ray is prescribed. Such fractures are often accompanied by damage to the lateral ligaments of the knee joint.

Treatment of fractures

At the same time, injuries in which the main bone is the tibia can be effectively treated. Anatomy advises setting the main goal of treating such a patient as restoring stable functioning of the joint, as well as establishing movement in it. Just a few days after the injury, it would not hurt to consult an orthopedic doctor who will give practical advice so that the recovery process goes optimally and quickly.

During treatment, reduction will most likely be necessary, which can be done in a closed manner by applying a plaster cast in the position of the leg in which it is in full extension. The bandage should be worn for one and a half to two months.

If the fracture is accompanied by other injuries, then closed reduction is best avoided.

If the ligaments are completely torn off, it is necessary to begin surgical treatment as quickly as possible. Such fractures are often accompanied by serious complications, severe pain, and unstable fixation of the knee joint.

Tibial ligament injury

Tibial ligaments are also susceptible to severe injury. The first symptom is a sharp pain on the inside of the knee that occurs immediately after the injury that caused the rupture. It is often difficult to pinpoint one source of pain.

It is necessary to provide first aid as quickly as possible. Place your leg in absolute rest. Applying cold will help relieve swelling and reduce pain. If required, you can take a painkiller tablet.

The fibula is a tubular, thin and long bone of the lower leg. It consists of a body and two epiphyses, upper and lower, respectively. The distal or lower end of the bone is an important component of the ankle joint and is called the lateral or lateral malleolus. The lateral malleolus is the external bony stabilizer of the ankle joint.

The structure of the fibula

The body of the bone has a prismatic triangular shape, curved posteriorly and twisted around the longitudinal axis. The fibula has three surfaces: posterior, lateral, and medial, which are separated from each other by three ridges.

The anterior edge has the shape of a sharp ridge and separates the lateral surface from the medial one. The medial ridge is located between the medial and posterior surfaces of the bone, and the posterior edge is located between the lateral and posterior surfaces. On the posterior surface there is a nutrient opening, which extends into the distally directed nutrient canal. The interosseous margin can be seen on the medial surface.

The upper epiphysis of the fibula forms the head, which is connected to the tibia through the articular surface. The upper part of the head has a pointed shape and is called the apex of the head. The head is separated from the body by the neck of the fibula.

The lower epiphysis of the bone forms the lateral malleolus. Its outer surface can be easily felt through the skin. On the medial surface of the lateral malleolus there is an articular surface through which the bone connects to the outer part of the talus. A little higher on the fibula there is a rough surface that connects to the fibular notch of the tibia.

On the posterior surface of the lateral ankle, you can see a trace of the peroneus longus tendon - the ankle groove.

Types of fibula fractures

Fractures occur at different levels of the fibula. Mostly, the bone breaks in the area of ​​the lateral malleolus. In turn, a fracture of the outer ankle of the leg occurs at its various levels. As a rule, a fracture of the fibula is accompanied by dislocation or subluxation of the foot, shortening of the bone and rupture of the distal interosseous syndesmosis.

There are oblique, comminuted, transverse, spiral and fragmentary fractures of the fibula.

The main symptoms of a fracture include:

• pain when palpating the outer ankle;
• edema;
• pain with axial load on the bone;
• pain in the ankle joint when moving.

Treatment of fibula fractures

The main goal of conservative treatment is the comparison and retention of bone fragments. A traumatologist performs reposition, which eliminates foot subluxation and displacement of fragments. If during the period of reduction of the fracture the reposition was successful and the condition of the fragments is satisfactory, the foot and lower leg are fixed with a plaster cast or a special orthosis.

If the reposition does not give satisfactory results and the displacement of the fragments persists, surgical treatment of the fibula is prescribed, which consists of several stages:

• open reduction of bone fragments is performed;
• foot subluxation is eliminated;
• bone fragments are fixed using implants (pin, screws, plate).

The tibia is the large and long bone of the lower leg. The bone consists of a body and two epiphyses - the lower distal and the upper proximal.

Structure of the tibia

The body of the bone has a triangular shape with three edges - anterior, medial and interosseous, and three surfaces - medial, posterior and lateral.

The front edge of the bone has a pointed shape and resembles a ridge in appearance. In the upper part it turns into tuberosity. The interosseous edge has a pointed shape and the appearance of a scallop. This ridge is directed towards the fibula. The medial surface of the bone is slightly convex and can be easily felt through the skin along with the anterior edge of the body of the tibia.

The lateral (anterolateral) surface of the bone is slightly concave. And the back surface has a flat shape. On the posterior surface there is a line of the soleus muscle, which stretches from the lateral condyle medially and downward. A little below there is a nutrient opening, which extends into the distally directed nutrient canal.

The proximal epiphysis of the tibia is slightly expanded. Its lateral parts are the lateral and medial condyles. Outside the lateral condyle is the flat fibular articular surface. At the top of the proximal epiphysis in the middle section there is an intercondylar eminence, in which two tubercles can be distinguished:

• internal medial intercondylar, behind which the posterior intercondylar field can be distinguished;
• external lateral intercondylar, in front of which is the anterior intercondylar field.

The two fields are the attachment point for the cruciate knee ligaments. On the sides of the intercondylar eminence along the upper articular surface, articular surfaces that have a concave shape - medial and lateral - stretch to each condyle. The concave articular surfaces are limited peripherally by the edge of the tibia.

The distal epiphysis of the bone has a quadrangular shape. On its lateral surface there is a fibular notch adjacent to the distal epiphysis of the fibula. The ankle groove runs along the posterior surface of the distal epiphysis. Anterior to the groove, the medial edge of the distal epiphysis of the tibia passes into the medial malleolus - a downward process that is easily palpated. The articular surface of the ankle is located on the lateral surface of the ankle. It passes into the lower surface of the bone and extends into the lower concave articular surface of the tibia.

Fracture of the tibia

All fractures of the tibia are divided into:

• oblique;
• transverse;
• intra-articular;
• fragmentary;
• splintered.

Intra-articular fractures include fractures of the medial malleolus and tibial condyles. The medial malleolus serves as the internal bony stabilizer of the ankle joint. As a rule, its fracture occurs as a result of twisting of the tibia with a fixed foot. Also often, a fracture of the medial malleolus occurs as a result of a non-physiological sudden rotation of the foot.

The main symptoms of tibial fractures:

• The tibia hurts when moving and palpating;
• Due to the displacement of bone fragments, the lower leg is deformed (the axis of the limb changes);
• Swelling occurs;
• It is impossible to carry out axial load on the leg.

Fractures are treated primarily through surgery. As a rule, the patient can put weight on the sore leg the very next day after surgery.

Tibia cyst

Quite often, when the tibia hurts, this may indicate the presence of a cyst.

A bone cyst is a disease in which a thickening forms in the cavity of the bone tissue.

The exact origin of bone cysts has not yet been clarified. It has been established that cysts of the tibia appear as a result of hemodynamic disorder in a limited area of ​​the bone. In fact, the formation of a cyst is a dystrophic process. The formation of cysts is based on impaired intraosseous circulation and activation of lysosomal enzymes, leading to the destruction of collagen, glycosaminoglycans and other proteins. According to the international classification, cysts are classified as tumor-like diseases.

A bone cyst can be solitary or aneurysmal. A solitary cyst develops over a long period of time and is more common in adolescence in males. An aneurysmal cyst occurs suddenly and develops quickly. Most often, an aneurysmal cyst occurs as a result of direct trauma to the bone.

Despite the general nature of these diseases, they are usually clearly distinguished, since they have different symptoms and radiological pictures.

The human tibia is part of the musculoskeletal system, performing a number of different tasks. Thus, we can distinguish such functions of the tibia as supporting and motor.

It belongs to the group of long tubular bones, so its structure has characteristics inherent in the group.

Where is the tibia located? The answer to this question can be found in the biology and anatomy section, where its location and structure are described in detail. So, it is referred to as the bones of the lower leg.

In anatomy, it occupies a medial position and is connected to the knee joint. The ankle joint is also formed on the reverse side.

External structure

The tibia has a second, Latin name - tibia.

In the external structure, there are 3 parts or sections: two ends (epiphyses) - proximal and distal, as well as a body connecting the 2 epiphyses.

At the proximal end, two small processes are formed - the medial and lateral condyles. To form a connection with the femur, the human leg has articular platforms. Between them is the intercondylar eminence, on which there are medial and lateral tubercles.

At the ends of the elevation, in front and behind, there are two pits, or fields. They serve to attach the ligaments of the tibia and knee joint. There is a capsule on the articular surfaces.

On the front surface of the bone there is a tuberosity (rough bulge) - the tuberosity of the tibia. The patella is attached to it, among other things).

The edges or edges - anterior, medial, and lateral, facing the fibula and serving as the point of attachment of the interosseous membrane, are called margo interossea. Between these edges surfaces are formed - medial, posterior and lateral. Some of them can be felt under the skin yourself - the anterior edge and the medial surface.

The lowest part of the bone in the anatomy of the leg is the distal epiphysis - at the bottom is the medial malleolus. Behind it is a groove for the tendon. There are formations at the bottom of the epiphysis. They are adapted to be attached to the foot.

Internal structure

The tibia belongs to the group of long tubular bones. Therefore, it has internal structural features that are characteristic of the entire class. The following parts are distinguished:

• The top of the bone is covered with periosteum. This is the outermost layer. It has channels through which vessels and nerves supplying the bone pass. These channels are also the connecting link between all layers of the tube. The periosteum is a connective tissue plate that is formed from fibrous fibers. They are located on the outside, and the inside is made of osteoblasts - they form a looser layer.
• Compact and spongy substances are distinguished. The latter lies a little deeper and has a special porous structure. It is formed by bone trabeculae. They are built from plates.
• Bone marrow. One of the most important parts of the body in which hematopoiesis occurs. It is found in the middle of the bones as a liquid and consists of two components: yellow and red. The yellow one consists of fat cells, and the other one consists of reticular tissue.
• Osteoblasts and osteoclasts destroy as well as create tissue. They are found in the red component of the bone marrow.

Functions of bone

The following tasks of the bone are distinguished: supporting or supporting, motor.

Among the ligaments of the tibia, the following are distinguished: anterior and posterior cruciate (attached to the intercondylar region), patellar ligament (to the tuberosity), tibial collateral.

Bone location

The tibia is located on the front and inner side of the lower leg. Its outlines are visible through the skin. It is thicker at the top. Forms the lower half of the knee joint. Below (under the kneecap) is the place where the muscles attach. Next is the main part, which has a tubular structure. It smoothly passes into the surface of the ankle joint, as well as into the ankle.

Possible causes of injury to the shin bones

The following causes of injury are distinguished:

• unprepared jump or fall from a height;
• kneecap injury (for example, falling while running fast);
• twisting of the limb at the ankle joint;
• receiving a strong blow with a heavy blunt object.

After receiving a leg injury, a person urgently needs to seek qualified help.

Damage classification

Damage to the part of the leg where the tibia is located can be divided into:

• fractures;
• epiphysiolysis;
• cracks;
• bruises.

They differ in the degree of trauma.

Fractures, in turn, are divided into:

• transverse; with such damage is caused perpendicular to the bone axis;
• oblique; when they reveal a violation of the structure at an angle other than 90 degrees;
• helical; in this case, the break line looks like a spiral;
• fragmentation; the bone is destroyed into several (usually more than 3) parts;
• intra-articular; in this case, the injury occurs to the medial malleolus and condyles.

In addition to those listed above, fractures are distinguished: open, closed. In the first case, soft tissue damage occurs. The result is an open wound and heavy bleeding. In the second case, parts of the destroyed bone do not rip through the skin and do not protrude outward.

The parts most susceptible to fractures are the ankles, the posterior and anterior parts of the tibia, and the condyles.

Symptoms and confirmation of diagnosis

Any fracture can be characterized by the following signs:

• pain in the place where the tibia is located, which is sharp and acute, both at rest and in dynamics; it can also be caused by pressing on the heel or foot;
• deformation of the lower leg, it is easy to notice upon examination;
• sensation of a cracking sound at the slightest change in the position of the leg;
• it is not possible to bend the leg due to severe pain;
• swelling of soft tissues, bruising;
• in the case of an open fracture, a profusely bleeding wound is visible.

To determine and correct the diagnosis, the doctor sends the patient for an x-ray of the tibia and lower leg. It is done in two projections of both limbs. Using the image, you can determine the severity of the injury, and based on it, the specialist can choose the treatment method and the necessary procedures.

If there is a fracture inside the joint, arthroscopy is performed. The procedure involves checking the ligaments inside the joint. If during the fracture the fibers of the nerve endings are touched and damaged, then electroneuromyography is performed. An MRI or CT scan may also be prescribed for a more in-depth analysis of the injury.

Treatment

In the event of a broken leg bone, first aid must be provided very quickly.

1. Immobilization of a limb. You need to apply a splint, which can be made from almost any available means.
2. Application of a tourniquet. It is carried out only in case of severe bleeding. The tourniquet is fixed below the wound in case of damage to the vein. In the case of an artery, it must be applied above the wounded area. Blood from an arterial vein is dark in color.
3. To prevent harmful microparticles from entering the body and the development of blood poisoning, it is necessary to remove all foreign bodies near the damaged area. Next, apply a sterile bandage with a disinfectant.
4. Take a pain reliever to relieve pain.

Then the victim must be quickly taken to the hospital. There, specialists will give him an accurate diagnosis, and then prescribe treatment.

If the bone is not displaced, then only a bandage is enough to fix the limb in one position in the place where the tibia is located.

More often, with displacements, traction of the skeleton is necessary. A medical needle is passed through the heel bone, and the injured limb is placed and fixed on a splint. A load is attached to it. Its weight is calculated individually for each person. It may depend on body weight, muscle condition, and type of injury.

Surgical intervention is required for complex fractures when primitive methods are not effective enough. The patient is under observation in the hospital for about a week. At this time, a comprehensive examination of the body and damaged bones is carried out.

Various metal structures are used for surgical intervention. They allow the osteosynthesis procedure to be performed. In normal cases, bone healing may take about a month.

Features during rehabilitation

To restore blood circulation and muscle tone, the following types of therapy are prescribed:

• massage of injured limbs;
• a course of exercises to strengthen ligaments and develop muscles (physical therapy, gymnastics);
• physiotherapy in clinics.