Ligament of Barkow

June 20, 2010

The superior tibiofibular joint is formed between the posterolateral aspect of the lateral condyle of the proximal tibial plateau and the fibular head. One of the lesser known stabilizers of this joint is the Ligament of Barkow.  This ligament can be found deep to the muscles of the anterior compartment of the leg just superior to the interosseous membrane.  Tubbs et al. (2009) dissected 20 cadavers (40 lower limbs) and found the Ligament of Barkow in 95% of specimens (38 out of 40). 

The ligament was found to run superolateral from the tibia to the neck of the fibula; the fibres run in the opposite direction to that of the interosseous membrane.  The upper edge of the ligament was on average 3cm inferior to the lower margin of the proximal tibiofibular joint. The ligament was on average 1.2 – 1.5 cm in width with the lower edge a mean distance of 7mm from the anterior tibial artery as it enters the anterior compartment of the leg.

The authors hypothesized that the Ligament of Barkow may offer added stability to the proximal tibiofibular joint by providing resistance to the posterior pull of the biceps femoris muscle, particularly when the knee is in extension. It was also hypothesized that the ligament resists rotation of the fibula and posterolateral displacement (interestingly 85% of proximal tibiofibular joint dislocations are anterolateral).

Tubbs et al. The clinical anatomy of the ligament of Barkow at the proximal tibiofibular joint. Surgical and Radiologic Anatomy 2009; 31: 161


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