Effect of axial load and ankle position on ankle stability

The range of motion of 10 fresh cadaveric ankle specimens was measured for flexion, anterior-posterior drawer, inversion-eversion, and internal-external rotation under conditions that simulated normal weight-bearing. At a 70 kg load, range of motion significantly diminished in all directions (p < 0.005). Plantar flexion was diminished to a greater degree than dorsiflexion. For anterior-posterior drawer in the loaded state, ankle flexion did not play a significant role in determining stability. Factors such as ligamentous attachments may be more critical than mortise geometry in determining anterior-posterior translation. For torsion and version, stability was greatest in dorsiflexion. That ankle stability is related to articular congruity with increased load-bearing emphasizes the importance of anatomical restoration of the ankle mortise in the injury state.