Morphology of the fibular insertion of the posterolateral corner and biceps femoris tendon.
OBJECTIVE
To clarify the fibular head insertion of the fibular collateral ligament (FCL), popliteofibular ligament (PFL), and biceps femoris tendon and related osseous landmarks on three-dimensional (3-D) images.


METHODS
Twenty-one non-paired, formalin-fixed human cadaveric knees were evaluated in this study. The fibular head insertions of the FCL, PFL and biceps femoris tendon were identified and marked. 3-D images were created, and the surface area, location, positional relationships, and morphology of the fibular insertions of the FCL, PFL, and biceps femoris tendon and related osseous structures were analysed.


RESULTS
The fibular head had a unique pyramidal shape, and the relationships of the fibular insertion of the FCL, PFL, and biceps femoris tendon were consistent. The fibular head consists of three aspects: lateral aspect, posterior aspect, and proximal tibiofibular facet. The insertions of the FCL, PFL, and biceps femoris tendon were attached to the centre from the distal side of the lateral aspects of the fibular head, posterior aspect of the fibular styloid process, and lateral aspect surrounding the FCL, respectively. The mean surface areas of the FCL and PFL fibular insertions were 100.1 ± 29.5 and 18.5 ± 7.2 mm2, respectively.


CONCLUSIONS
This study showed that the relationships between the characteristic features of the fibular head and insertions of the FCL, PFL, and biceps femoris tendon were consistent. The clinical relevance of this study is that it improves understanding of the anatomy of the insertions of the PLC and biceps femoris tendon.
Department of Orthopaedic Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
Hirotaka
H
Takahashi
Department of Orthopaedic Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan. goro.t@triton.ocn.ne.jp.
Goro
G
Tajima
Department of Orthopaedic Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
Shuhei
S
Kikuchi
Department of Anatomy, Iwate Medical University, Morioka, Japan.
Jun
J
Yan
Department of Orthopaedic Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
Yoichi
Y
Kamei
Department of Orthopaedic Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
Moritaka
M
Maruyama
Department of Orthopaedic Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
Atsushi
A
Sugawara
Department of Orthopaedic Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
Takaaki
T
Saigo
Department of Orthopaedic Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
Minoru
M
Doita
D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D005260:Female; D005360:Fibula / Q000033:anatomy & histology*; D000070632:Hamstring Tendons / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007719:Knee Joint / Q000033:anatomy & histology*; D008023:Ligaments, Articular; D008297:Male; D008875:Middle Aged
Fibular collateral ligament; Fibular insertion; Popliteofibular ligament; Posterolateral corner