Int J Sports Med 2017; 38(07): 546-550
DOI: 10.1055/s-0043-106741
Orthopedics & Biomechanics
© Georg Thieme Verlag KG Stuttgart · New York

MRI Identification of the Fibular and Talus Position in Patients with Mechanical Ankle Instability

Hong-Yun Li
1   Department of Sports Medicine and Arthroscopy Surgery, Sports Medicine Center of Fudan University, Huashan Hospital, Shanghai, China
,
Ru-Shou Zhou
2   Department of Orthopaedic, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China
,
Ying-Hui Hua
3   Department of Sports Medicine, Sports Medicine Center of Fudan University, Huashan Hospital, Shanghai, China
,
Shi-Yi Chen
1   Department of Sports Medicine and Arthroscopy Surgery, Sports Medicine Center of Fudan University, Huashan Hospital, Shanghai, China
› Author Affiliations
Further Information

Publication History



accepted 07 March 2017

Publication Date:
08 May 2017 (online)

Abstract

Specific anatomic variations of the ankle mortise may be found in people with ankle instability. The purpose was to evaluate the fibular and talus position in subjects with mechanical ankle instability (MAI). In this study, MR images of 54 patients with MAI and 51 patients from the author’s institution for reasons unrelated to ankle instability were reviewed. The position of the fibular in relation to the talus (axial malleolar index, AMI) and medial malleolus (intermalleolar index, IMI) were evaluated at the axial plane. Meanwhile, the rotation of the talus was measured and calculated using a new index, the Malleolar Talus Index (MTI), which is measured in relation to the medial malleolar. The results showed that the AMI in the MAI patients increased significantly when compared to that in the control group. However, there was no statistically significant difference in the IMI between instability and control groups. The MTI increased significantly in the MAI patients when compared to that in the control group. The conclusion was that the patients with MAI have more of an internally rotated talus than a variation of fibular position.

 
  • References

  • 1 Berkowitz MJ, Kim DH. Fibular position in relation to lateral ankle instability. Foot Ankle Int 2004; 25: 318-321
  • 2 Beynnon BD, Murphy DF, Alosa DM. Predictive factors for lateral ankle sprains: a literature review. J Athl Train 2002; 37: 376-380
  • 3 Bischof JE, Spritzer CE, Caputo AM, Easley ME, DeOrio JK, Nunley 2nd JA, DeFrate LE. In vivo cartilage contact strains in patients with lateral ankle instability. J Biomech 2010; 43: 2561-2566
  • 4 Bonnel F, Toullec E, Mabit C, Tourné Y. Sofcot . Chronic ankle instability: Biomechanics and pathomechanics of ligaments injury and associated lesions. Orthop Traumatol Surg Res 2010; 96: 424-432
  • 5 Bozkurt M, Doral MN. Anatomic factors and biomechanics in ankle instability. Foot Ankle Clin 2006; 11: 451-463
  • 6 Bremer SW. The unstable ankle mortise: functional ankle varus. J Foot Surg 1985; 24: 313-317
  • 7 Caputo AM, Lee JY, Spritzer CE, Easley ME, DeOrio JK, Nunley 2nd JA, DeFrate LE. In vivo kinematics of the tibiotalar joint after lateral ankle instability. Am J Sports Med 2009; 37: 2241-2248
  • 8 Cass JR, Settles H. Ankle instability: In vitro kinematics in response to axial load. Foot Ankle Int 1994; 15: 134-140
  • 9 Chen H, Li HY, Zhang J, Hua YH, Chen SY. Difference in postural control between patients with functional and mechanical ankle instability. Foot Ankle Int 2014; 35: 1068-1074
  • 10 Denegar CR, Miller 3rd SJ. Can chronic ankle instability be prevented? Rethinking management of lateral ankle sprains. J Athl Train 2002; 37: 430-435
  • 11 Eren OT, Kucukkaya M, Kabukcuoglu Y, Kuzgun U. The role of a posteriorly positioned fibular in ankle sprain. Am J Sports Med 2003; 31: 995-998
  • 12 Frigg A, Frigg R, Hintermann B, Barg A, Valderrabano V. The biomechanical influence of tibio-talar containment on stability of the ankle joint. Knee Surg Sports Traumatol Arthrosc 2007; 15: 1355-1362
  • 13 Frigg A, Magerkurth O, Valderrabano V, Ledermann HP, Hintermann B. The effect of osseous ankle configuration on chronic ankle instability. Br J Sports Med 2007; 41: 420-424
  • 14 Fujii T, Kitaoka HB, Watanabe K, Luo ZP, An KN. Ankle stability in simulated lateral ankle ligament injuries. Foot Ankle Int 2010; 31: 531-537
  • 15 Garrick JG. The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med 1977; 5: 241-242
  • 16 Harriss DJ, Atkinson G. Ethical standards in sport and exercise science research: 2016 Update. Int J Sports Med 2015; 36: 1121-1124
  • 17 Hertel J, Olmsted-Kramer LC. Deficits in time-to-boundary measures of postural control with chronic ankle instability. Gait Posture 2007; 25: 33-39
  • 18 Hintermann B. Biomechanics of the unstable ankle joint and clinical implications. Med Sci Sports Exerc 1999; 31: S459-S469
  • 19 Hollis JM, Blasier RD, Flahiff CM. Simulated lateral ankle ligamentous injury. Change in ankle stability. Am J Sports Med 1995; 23: 672-677
  • 20 Hubbard TJ, Hertel J, Sherbondy P. Fibular position in individuals with self-reported chronic ankle instability. J Orthop Sports Phys Ther 2006; 36: 3-9
  • 21 Johnson EE, Markolf KL. The contribution of the anterior talofibular ligament to ankle laxity. J Bone Joint Surg Am 1983; 65: 81-88
  • 22 Kavanagh J. Is there a positional fault at the inferior tibiofibular joint in patients with acute or chronic ankle sprains compared to normals?. Man Ther 1999; 4: 19-24
  • 23 Konradsen L, Bech L, Ehrenbjerg M, Nickelsen T. Seven years follow-up after ankle inversion trauma. Scand J Med Sci Sports 2002; 12: 129-135
  • 24 Leardini A, O'Connor JJ, Catani F, Giannini S. The role of the passive structures in the mobility and stability of the human ankle joint: A literature review. Foot Ankle Int 2000; 21: 602-615
  • 25 LeBrun CT, Krause JO. Variations in mortise anatomy. Am J Sports Med 2005; 33: 852-855
  • 26 Mavi A, Yildirim H, Gunes H, Pestamalci T, Gumusburun E. The fibular incisura of the tibia with recurrent sprained ankle on magnetic resonance imaging. Saudi Med J 2002; 23: 845-849
  • 27 McDermott JE, Scranton Jr PE, Rogers JV. Variations in fibular position, talar length, and anterior talofibular ligament length. Foot Ankle Int 2004; 25: 625-629
  • 28 O'Loughlin PF, Murawski CD, Egan C, Kennedy JG. Ankle instability in sports. Phys Sportsmed 2009; 37: 93-103
  • 29 Rasmussen O. Stability of the ankle joint. Analysis of the function and traumatology of the ankle ligaments. Acta Orthop Scand Suppl 1985; 211: 1-75
  • 30 Rasmussen O, Tovborg-Jensen I. Mobility of the ankle joint: recording of rotatory movements in the talocrural joint in vitro with and without the lateral collateral ligaments of the ankle. Acta Orthop Scand 1982; 53: 155-160
  • 31 Renström PA, Konradsen L. Ankle ligament injuries. Br J Sports Med 1997; 31: 11-20
  • 32 Scranton Jr PE, McDermott JE, Rogers JV. The relationship between chronic ankle instability and variations in mortise anatomy and impingement spurs. Foot Ankle Int 2000; 21: 657-664
  • 33 Stormont DM, Morrey BF, An KN, Cass JR. Stability of the loaded ankle. Relation between articular restraint and primary and secondary static restraints. Am J Sports Med 1985; 13: 295-300
  • 34 Sugimoto K, Samoto N, Takakura Y, Tamai S. Varus tilt of the tibial plafond as a factor in chronic ligament instability of the ankle. Foot Ankle Int 1997; 18: 402-405
  • 35 Tochigi Y, Rudert MJ, Saltzman CL, Amendola A, Brown TD. Contribution of articular surface geometry to ankle stabilization. J Bone Joint Surg Am 2006; 88: 2704-2713
  • 36 Van Bergeyk AB, Younger A, Carson B. CT analysis of hindfoot alignment in chronic lateral ankle instability. Foot Ankle Int 2002; 23: 37-42
  • 37 Wainright WB, Spritzer CE, Lee JY, Easley ME, DeOrio JK, Nunley JA, DeFrate LE. The effect of modified Broström-Gould repair for lateral ankle instability on in vivo tibiotalar kinematics. Am J Sports Med 2012; 40: 2099-2104
  • 38 Watanabe K, Kitaoka HB, Berglund LJ, Zhao KD, Kaufman KR, An KN. The role of ankle ligaments and articular geometry in stabilizing the ankle. Clin Biomech (Bristol, Avon) 2012; 27: 189-195