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The American Journal of Sports Medicine 31:995-998 (2003)
© 2003 American Orthopaedic Society for Sports Medicine

The Role of a Posteriorly Positioned Fibula in Ankle Sprain

Osman Tugrul Eren, MD*, Metin Kucukkaya, MD, Yavuz Kabukcuoglu, MD and Unal Kuzgun, MD

From the First Department of Orthopaedic Surgery, Sisli Etfal Research and Training Hospital, Istanbul, Turkey

* Address correspondence and reprint requests to Osman Tugrul Eren, MD, Akatlar Mah. Yesim sokak. Manolya A Blok No:29, K:5, D:12, 34335, Besiktas, Istanbul, Turkey

Background: Specific anatomic variations of the ankle mortise may predispose people to ankle sprains.

Hypothesis: There is a correlation between a higher malleolar index (posteriorly positioned fibula) and incidence of ankle sprain.

Study Design: Prospective case control study.

Methods: We compared the malleolar index (transverse plane of the talus) on computerized axial tomographic images of 61 patients with ankle sprain with that of 101 normal controls. A positive number for the malleolar index meant that the lateral malleolus was posterior to the plane of the medial malleolus. A negative number meant that the lateral malleolus was actually anterior to the plane of the medial malleolus.

Results: The average malleolar index of the patients with ankle sprain was +11.5° with a standard deviation of 7°. Malleolar relationships varied from –6° to +39°, a range of 45°. The average malleolar index in the control group was +5.85° with a standard deviation of 4.9°, which varied from –8° to +16°. However, there was no correlation between recurrence of sprains and malleolar index values.

Conclusion: Patients with an ankle sprain were more likely to have a posteriorly positioned fibula, possibly predisposing them to ankle sprain.




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Home page
 Am J Sports MedHome page
C. T. LeBrun and J. O. Krause
Variations in Mortise Anatomy
Am. J. Sports Med., June 1, 2005; 33(6): 852 - 855.
[Abstract] [Full Text] [PDF]


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