Effect of Q-angle, lateral distal tibial angle and hip muscle torques on ankle injury

The ankle sprain is the most common ankle injury. Although the factors that increase the risk of ankle injury are included in the literature, the definitive evidence is controversial.

The aim of our study was to examine whether Q-angle, lateral distal tibial angle (LDTA), and hip muscle torque are associated with ankle sprain.

Thirty-six individuals who underwent an axial X-ray examination of the lower extremity following ankle sprain were included. The Q-angle and LDTA were measured on the axial knee X-rays on both sides. The isometric muscle strength was measured with a digital handheld dynamometer for the quadriceps femoris muscle, the gluteus medius muscle and the gluteus maximus muscle. Muscle torques were calculated by multiplying isometric muscle strength values with the distance to the joint center.

Discrimination analysis shows that the gluteus maximus (0.90), gluteus medius (0.49), quadriceps femoris muscle torques (0.34), and lateral distal tibial angle (0.43) were the factors that most contributed to ankle sprain. No significant relationship was found between the Q-angle and ankle sprain (p = 0.603). A strong relationship was found between LDTA, quadriceps femoris, gluteus medius and gluteus maximus muscle torques and ankle sprain (p = 0.014, p < 0.001, p = 0.011, p = 0.002, respectively).

In conclusion, the torques of the proximal muscle may be more related than the Q-angle to lateral ankle sprain injury. Individuals with high LDTA should also be carefully examined for the risk of ankle sprain.