Home › Body Atlas › Bones › Fibular Notch of the Tibia

Fibular Notch of the Tibia

incisura fibularis tibiae

The fibular notch (incisura fibularis) is the lateral concavity of the distal tibia that accommodates the fibula at the ankle syndesmosis. The notch is deepest posteriorly (where the posterior tibiofibular ligament inserts) and shallower anteriorly. The anterior and posterior tibiofibular ligaments and the interosseous membrane attach here, forming the distal tibiofibular syndesmosis. The shape of the notch (depth and width) affects syndesmotic reduction accuracy.

Region: Lower Leg

Clinical Relevance

Clinical Notes

The fibular notch is the key reference for ankle syndesmosis reduction accuracy. Syndesmotic malreduction (fibula not seated properly in the notch) occurs in 10-30% of ankle fracture ORIF cases and leads to poor outcomes with post-traumatic arthritis. CT assessment of the fibular position within the notch — comparing to the contralateral ankle — is increasingly used intraoperatively and post-operatively to detect malreduction before it becomes symptomatic. The contour of the notch also affects the adequacy of syndesmotic implant fixation.

Pathology

Common Injuries & Conditions

Syndesmotic Malreduction Detected by CT of Fibular Notch

Ankle fracture ORIF may leave the fibula malreduced within the fibular notch of the tibia — rotated, translated anteriorly, or shortened — producing a congruent-appearing ankle on fluoroscopy but abnormal syndesmosis on CT; intraoperative CT or post-operative CT comparing fibular position in the notch to the contralateral side identifies malreduction requiring revision before the screw is removed.