The distal fibular shaft is the segment of the fibula in the distal 5-6 cm above the lateral malleolus, where the peroneal tendons begin their posterior groove and the peroneal muscles transition to their tendinous portions. This region is the most common site of fibular stress fractures and the zone at risk in ankle fractures.
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| Ossification | Distal fibular epiphysis appears at age 1-2 and fuses at age 15-17 years, creating the growth plate that must not be mistaken for a fracture in paediatric ankle injuries (Salter-Harris classification applies here). |
The distal fibular shaft, specifically 6 cm above the tip of the lateral malleolus, is the location of the Weber B ankle fracture at the level of the syndesmosis. Stress fractures of the distal fibula occur at this level in runners and dancers. The peroneal tendons begin their posterior course at the distal fibular shaft level, where they are at risk of damage in lateral ankle sprains. Hardware from prior ankle fracture fixation commonly occupies this level.
A fibular fracture above the syndesmosis indicating syndesmotic disruption, usually needing fixation.
Runners commonly develop stress fractures just above the lateral malleolus.
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