The interosseous membrane of the leg connects the medial fibula to the lateral tibia throughout the leg length, with fibres oriented at approximately 70 degrees to the bones, transmitting axial load from fibula to tibia and resisting fibular lateral displacement.
Transmits approximately 17% of axial load from the fibula to the tibia, maintains the tibiofibular relationship essential for ankle mortise stability, acts as the origin for the anterior and posterior compartment muscles, and is the route through which the anterior tibial artery passes anteriorly.
The interosseous membrane is disrupted in high-energy ankle fractures (Maisonneuve fracture — proximal fibular fracture with interosseous membrane tear extending to the ankle), producing unstable ankle mortise that requires syndesmotic fixation despite the proximal fibular fracture location.
Proximal fibular fracture with interosseous membrane tear producing unstable ankle mortise without distal fibular fracture, managed by syndesmotic screw or TightRope fixation and proximal fracture protection.
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