Finite element analysis of the Fibula's contribution to lower extremity torsional stiffness

Aims: The purpose of this article is to investigate the effects of the fibula on the torsional stiffness of the lower limb. A comprehensive model of the lower limb was constructed, including the resected femur, patella, tibia, fibula, and foot, with tendons and ligaments. Two configurations were developed, with and without the presence of the fibula, to evaluate the resulting stress state and consequently determine the contribution of the fibula to the torsional stiffness of the lower limb. Methods: The finite element method was used to analyse how the fibula affects the stress distribution in the lower extremity under body weight loading and torsional forces. A detailed three-dimensional solid model of the lower extremity with and without the fibula was constructed. Loading conditions were imposed simulating an axial compressive load of 700 N applied to the upper extremity of the resected femur and a torsional load of 6000 Nmm applied to the proximal femur, and a fixed constraint was imposed on the foot. Results: Removing the fibula results in an increase in stress on all the tendons and ligaments tested. The increases ranged from 4 % (patellar tendon) to 21 % (lateral retinaculum). This suggests that the fibula plays a significant role in the distribution of mechanical stress in the lower extremity. The most affected structures are the lateral retinaculum and the posterior cruciate ligament, both with a 21 % increase in stress, suggesting that these structures may compensate more for the absence of the fibula. Conclusion: The fibula plays a critical role in maintaining the structural integrity and biomechanical function of the lower extremity. It acts as a lateral strut, contributing to the stability of the ankle and knee by providing an attachment point for several muscles and ligaments that are essential for coordinating complex movements and providing stability during dynamic activities.