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Related Experiment Video

Updated: Jul 16, 2026

In situ Compressive Loading and Correlative Noninvasive Imaging of the Bone-periodontal Ligament-tooth Fibrous Joint

In situ Compressive Loading and Correlative Noninvasive Imaging of the Bone-periodontal Ligament-tooth Fibrous Joint

Published on: March 7, 2014

Variations in mortise anatomy.

Christopher T LeBrun¹, John O Krause

¹Wilford Hall Medical Center, San Antonio, Texas, USA. ctlebrun@hotmail.com

The American Journal of Sports Medicine

|April 14, 2005

Summary

Ankle instability may not stem from fibular positioning, but rather from how measurements are taken. A new method shows no significant difference in fibular position between stable and unstable ankles.

Area of Science:

Orthopedics
Radiology
Anatomy

Background:

Ankle instability is a common clinical problem.
Anatomical variations of the ankle mortise may predispose individuals to instability.
Previous studies suggested a posteriorly positioned fibula as a potential cause.

Purpose of the Study:

To investigate the relationship between fibular position and ankle instability.
To evaluate a new measurement technique for assessing fibular position independent of talar rotation.
To determine if a posteriorly positioned fibula is a true pathologic finding or a measurement artifact.

Main Methods:

Retrospective review of 60 ankle computed tomography (CT) scans from a control group and 21 CT scans from patients with ankle instability.

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Last Updated: Jul 16, 2026

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Published on: March 7, 2014

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Calculation of the axial malleolar index (Scranton et al.) and a novel intermalleolar index referencing the medial malleolus.

Comparison of measurements between the control and ankle instability groups.

Main Results:

The axial malleolar index showed a significant difference between control and instability groups (P < .01).
However, the novel intermalleolar index revealed no significant difference between the groups (P = .43).
This suggests the talar rotation influences the axial malleolar index measurement.

Conclusions:

The intermalleolar index provides a more reliable assessment of fibular position, independent of talar rotation.
Fibular position does not significantly differ between patients with and without ankle instability when measured using a talus-independent method.
A posteriorly positioned fibula in ankle instability may be an artifact of measurement rather than a true pathologic entity.