The fibular shaft is the slender diaphysis of the fibula running between the fibular head and the lateral malleolus, largely surrounded by muscle with no direct weight-bearing function. Its surfaces provide attachment for the peroneal muscles laterally and the deep posterior compartment muscles medially. The interosseous crest of the fibula faces the tibia and provides the lateral attachment of the interosseous membrane.
The fibular shaft is harvested as the most commonly used vascularised bone graft in reconstructive surgery, based on the peroneal artery. Fibular free flaps reconstruct mandible, tibia, femur, and spine defects up to 25 cm in length. Isolated fibular shaft fractures from direct trauma (nightstick equivalent) heal without surgery when the interosseous membrane and syndesmosis are intact. Stress fractures of the fibular shaft occur in runners, typically in the distal third.
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