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Separated ossicles of the lateral malleolus
A Hasegawa1, M Kimura, S Tomizawa
1Department of Orthopaedic Surgery, Gunma Social Welfare Central General Hospital, Japan.
Clinical Orthopaedics and Related Research
|September 1, 1996
Summary
Symptomatic ossicles of the lateral malleolus can cause ankle instability. The severity of the ossicle-fibular tip gap, not size, correlates with chronic symptoms and instability.
Area of Science:
- Orthopedics
- Sports Medicine
- Anatomy
Background:
- Symptomatic ossicles of the lateral malleolus are a recognized cause of ankle pain.
- The relationship between the ossicle and the fibular tip is crucial for ankle stability.
Purpose of the Study:
- To classify ossicles of the lateral malleolus based on size, location, and relationship to the fibular tip.
- To correlate these classifications with clinical findings, particularly ankle instability.
Main Methods:
- Clinical and radiographic examinations of 59 patients (60 ankles).
- Stress arthrography, arthroscopy, operative treatment, and histologic examination were performed.
- Ossicles were classified by size, level, and relationship to the fibular tip (arthrography grades and operative types).
Main Results:
- Significant differences in talar tilt angles on stress radiography were observed between arthrography grades.
- Chronic symptoms and instability increased with larger gaps (Grade 3) and poorer continuity (Type C/D) between the ossicle and fibular tip.
- Ossicle size and level did not correlate with instability.
Conclusions:
- The degree of separation or continuity between the ossicle and fibular tip is a key factor in ankle instability.
- Inversion forces may damage this connection, leading to symptomatic ossicles and chronic ankle instability.