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Assessing fibular length using bimalleolar angular measurements.

B Rolfe¹, W Nordt, J G Sallis

¹Department of Orthopaedic Surgery, Montefiore Medical Center, North Central Bronx Hospital, NY.

|October 1, 1989

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Assessing fibular shortening after ankle fractures is challenging. New angular measurements, the talocrural and bimalleolar angles, help detect abnormal fibular length changes, guiding therapy for better ankle biomechanics.

Area of Science:

Orthopedics
Radiology
Biomechanics

Background:

Fibular shortening after ankle fractures is common and difficult to assess.
Loss of lateral malleolar anatomy significantly impacts ankle biomechanics and clinical outcomes.

Purpose of the Study:

To evaluate angular measurements for assessing distal fibular length after ankle fractures.
To establish a reliable method for detecting fibular reduction and shortening.

Main Methods:

Mortise view X-rays of 50 normal ankles were analyzed.
Talocrural and a new bimalleolar angle were measured and compared between contralateral ankles.
Radiographic measurements were correlated with fibular length changes using cadaver studies.

Main Results:

Related Experiment Videos

The bimalleolar angle proved simpler and more reproducible than the talocrural angle.
A 1-degree angular change corresponded to a 1 mm change in fibular length.
Abnormal shortening is detected with a contralateral difference of 3.0 degrees (talocrural) or 2.5 degrees (bimalleolar).

Conclusions:

The bimalleolar angle is a reliable tool for assessing fibular length after ankle fractures.
Angular measurements can accurately detect significant fibular shortening.
A contralateral difference of 2.5-3.0 degrees warrants therapeutic consideration.