Distal anterior tubercle of fibula

The distal anterior tubercle of the fibula (Anterior tubercle; Wagstaffe tubercle) is a bony prominence located on the anterolateral aspect of the distal fibula, just proximal to the lateral malleolus. This tubercle serves as the attachment site for the anterior tibiofibular ligament, which is a key stabilizer of the distal tibiofibular syndesmosis and thus the ankle mortise.

The anterior tubercle is palpable and radiographically identifiable, lying anterior and slightly proximal to the articular surface of the lateral malleolus. It is clinically significant as it is involved in certain fracture patterns (e.g., Wagstaffe fracture, which is an avulsion of the tubercle by the AITFL) and serves as a landmark for surgical approaches and syndesmotic fixation.

The tubercle is typically described as a small, rounded or spike-like projection, and its morphology can vary among individuals. It is consistently present and reliably used to localize the origin of the AITFL, which runs obliquely from the anterior tubercle of the fibula to the anterior margin of the tibial incisura. The region is also adjacent to the fibular obscure tubercle, another bony landmark used in minimally invasive lateral ankle stabilization procedures.