[The lower ankle joint. Anatomic and pathophysiologic observations].

Area of Science:

• Orthopedics and Sports Medicine
• Biomechanics
• Radiology

Background:

• The lower ankle joint exhibits significant variability in ligamentous support.
• Instability is often linked to the upper ankle joint and is pronounced in the supination position.
• Clinical instability of the lower ankle joint requires diagnostic evaluation.

Purpose of the Study:

• To investigate the biomechanical characteristics of the lower ankle joint.
• To explore radiological methods for assessing lower ankle joint instability.
• To propose and discuss a surgical approach for combined upper and lower ankle joint instability.

Main Methods:

• Biomechanical analysis of lower ankle joint stability, particularly in supination.
• Utilization of radiological techniques to obtain radiographic evidence of instability.
• Development and detailed discussion of a surgical strategy for treating combined ankle joint instability.

Main Results:

• Biomechanical studies indicate relative instability in the posterior lower ankle joint, especially during supination.
• Radiological techniques can provide objective evidence of clinical instability.
• A surgical approach for managing instability in both the upper and lower ankle joints has been formulated.

Conclusions:

• The lower ankle joint's instability, particularly in supination, necessitates consideration of the entire ankle complex.
• Radiological assessment is crucial for diagnosing lower ankle joint instability.
• A comprehensive surgical approach addressing both upper and lower ankle joint instability is presented.