Fibular head anterior

The fibular head, lateral to the knee joint, should be articulated in an anterior/posterior glide. Because of the combined mechanics with the ankle mortise, a posterior glide somatic dysfunction is the most common knee somatic dysfunction with anterior glide the next. 

Increased anterior slide with decreased posterior slide signifies anterior fibular head dysfunction increased posterior slide with decreased anterior slide signifies posterior fibular head dysfunction. 

The body of the talus is wedge-shaped and wider in its anterior portion. Dorsiflexion creates a close-packed position of the talus in the crural arch. Further dorsiflexion induces separation of the tibiofibular articulation, with lateral and caudal displacement of the distal fibula and medial rotation around the tibia. This motion of the fibula can be a major source of fibular head dysfunction. 

An anterior fibular head is accompanied by foot eversion, forefoot abduction, and lower leg external rotation. 

The physician s cephalad hand stabilizes the patient s bent knee and holds the anterior fibular head with his thenar eminence. 

FIG. 100-1 High-velocity, low-amplitude thrusting technique for an anterior fibular head dysfunction. 

Fig. 14.10a-d. Anatomy of the peroneal nerve, a Schematic drawing of a lateral view of the knee illustrates the course of the common peroneal nerve (curved arrows) which branches from the sciatic nerve (black arrow) at the apex of the popliteal fossa and descends posterior to the biceps femoris muscle (Bf) and tendon (asterisk) to turn anteriorly around the fibular head. The nerve then continues down between the lateral side of the neck of the fibula and the peroneus longus muscle (PI). Here the peroneal nerve divides into its two terminal branches, the superficial peroneal nerve (white arrowhead) and the deep peroneal nerve (white arrow), md sends a recurrent articular branch (open arrowhead).b-d Transverse Tl-weighted MR images obtained at the levels indicated in a (horizontal bars) reveal the normal position of the common peroneal nerve (curved arrow) relative to the biceps tendon, the crural fascia (open arrowhead) fibular head (FH). Note the relationships of the main trunk and the superficial (white arrowhead) and deep (white arrow) peroneal nerves with the fibular and neck (FN). Black arrow, tibial nerve... 

Just deep to the proximal part of the lateral collateral ligament, the popliteus tendon can be imaged on coronal US planes as an oval structure located in its bony groove (Fig. 14.34). Depending on the incidence of the US beam, substantial anisotropy may be evident in the popliteus tendon (De Maeseneer et al. 2002). The US examination of the lateral aspect of the knee should be completed with an evaluation of the superior tibiofibular joint. Transverse and coronal US scans obtained over the anterior aspect of the fibular head are adequate for this purpose. 

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