The congenital ball-and-socket ankle joint is a rare condition and is associated with congenital shortening of the lower extrimity and various skeletal abnormalities of the foot. This disease entity was reported in the German literature by Politzer in 1931 and in the English literature by Lamb in 1958. Several series have been reported since, suggesting that the condition may not be as rare as generally thought. This case is, to our knowledge, the first reported in this country.
Ankle Joint ; Ankle ; Foot

PURPOSE: To introduce reliable and newly developed radiographic measures based on a lateral ankle radiograph to assess a syndesmotic reduction after screw fixation and to compare with the radiographic measures based on the anteroposterior (AP) and mortise radiographs. MATERIALS AND METHODS: The postoperative ankle radiographs of 34 ankle fracture cases after screw fixation for concurrent syndesmosis injury were reviewed. Two radiographic parameters were measured on each AP and mortise radiograph; tibiofibular clear space (TFCS) and tibiofibular overlap (TFO). Five radiographic parameters were measured on the true lateral radiographs; the anteroposterior tibiofibular (APTF) ratio, anterior tibiofibular ratio (ATFR), posterior tibiofibular ratio (PTFR), distances of intersection of the anterior fibular border and the tibial plafond to anterior cortex of the tibia (AA′), and the intersection of posterior fibular border and tibial plafond to the tip of the posterior malleolus (BB′). In addition, the distance (XP) between the fibular posterior margin (X) crossing tibial plafond or the posterior malleolus and posterior articular margin (P) of the tibial plafond was measured on the lateral view. RESULTS: Using TFCS and TFO in the AP and mortise radiographs, malreductions of syndesmosis were estimated in 17 of 34 cases (50.0%). Using the introduced and developed radiographic measures in the lateral radiographs, syndesmotic malreductions were estimated in 16 out of 34 cases (47.1%). Seventeen cases (50.0%) showed no evidence of postoperative diastasis using the radiographic criteria on the AP and mortise view, 10 cases (58.8%) of whom showed evidence of a malreduction on the lateral radiograph. The newly developed measurements, XP, were measured 0 in 11 out of 34 cases (32.4%). CONCLUSION: The reduction of syndemosis after screw fixation can be accurately assessed intraoperatively with a combination of several reliable radiographic measurements of the lateral radiograph and traditional radiographic measurements of the AP and mortise radiograph.
Ankle Fractures ; Ankle Joint ; Ankle* ; Diagnosis ; Tibia

In the classical ballet dancers, ankle joints are frequently overused. Especially the Pointe and the Releve are the two basic steps of ballet dance which cause the narrowing of the posterior aspect of the ankle joint. Posterior impingement syndrome of the ankle joint is defined as impingement occuring at the anatomical interval between the posterior tibial articular surface and os calcis. The purpose of this study is to describe the anatomy and etiology of this injury and to review the non-operative and operative treatments. Sixteen cases of posterior impingment syndrome had been treated between March 1994 and March 1995. Ten dancers were professional and six were students. The patients was divided 3groups by etiologic factor. Group 1 is anatomical problem factor, Group 2 is overuse factor and Group 3 is ankle sprain factor. Thirteen dancers (81.2%) improved with conservative treatment including local steroid injection. Among the other three dancers, operation was performed in one case. The other two cases stopped dancing. The result was good in one dancer after operation. In the classic ballet dancers, posrerior impingement syndrome was frequent disorder and major etiologic factors are anatomical problem and overuse. Operation was necessary in only group l. It is good result in conservative treatment and operation.
Ankle Injuries ; Ankle Joint* ; Ankle* ; Dancing ; Humans

PURPOSE: This study aimed to investigate and compare the micro-structural profiles of trabecular bone from different facets at the ankle joint. MATERIALS AND METHODS: In a fresh cadaver ankle, four cored 10 mm of diameter cylindrical specimens of trabecular bone were harvested from the distal tibia, the talar dome, the medial malleolus, and the lateral malleolus. Using a micro-computed tomography, two-dimensional and three-dimensional micro-structural indices of the trabecular bone were analyzed. RESULTS: Each specimen from the tibia, talus, medial malleolus, and the lateral malleolus showed unique micro-structural pattern. Tibia versus talus, the talus was seen a higher bone volume fraction and a wider supporting zone subchondrally whereas the tibia was seen a relatively lower bone volume fraction and a much narrower supporting zone subchondrally. Lateral malleolus versus medial malleolus, the lateral malleolus was seen the thicker but sparse trabeculae pattern whereas the medial malleolus was seen the thinner but more compact trabecular pattern. CONCLUSION: Each four locations from the different facet at the ankle joint have distinct own micro-structural patterns of the trabecular bone, suggesting different mechanical properties.
Ankle Joint* ; Ankle* ; Cadaver ; Talus ; Tibia

PURPOSE: The purpose of this study was to classify posterior malleolar fractures according to the position of fragments and to analyze radiologic features of each type. MATERIALS AND METHODS: We analyzed forty-six patients of ankle fractures involving a posterior malleolus who were treated between January 2004 and December 2007. The posterior malleolar fractures were categorized into three types (posterolateral, posteromedial, shell) based on the major fracture line. In each type, we analyzed amount of displacement, involvement of articular surface, existence of subluxation and osteochondral impacted fragments. RESULTS: The forty-six patients were categorized into three types: Posterolateral (PL) type (33 cases, 72%), Posteromedial (PM) type (8 cases, 17%), shell type (5 cases, 11%). Of the 8 cases with PM type, 7 cases showed displacement more than Grade II, 4 cases showed subluxation of ankle joint, and 3 cases showed osteochondral impacted fragment. Average involvement of articular surface of PM type is 35% (15~65%). CONCLUSION: Posterior malleolar fractures with medial extension tended to have adverse effect on ankle stability and Preoperative CT scan is essential for evaluation of fracture type and determination of appropriate surgical approach.
Animals ; Ankle ; Ankle Joint ; Displacement (Psychology) ; Humans

Impingement syndrome of the ankle is defined as painful mechanical limitation of full ankle movement secondary to osseous and/or soft tissue abnormality. These conditions occur more commonly in active people and athletes probably because recurrent subclinical injury is an important factor in development of the syndrome. Impingement syndromes of the ankle are categorized according to their anatomical site around the ankle joint. Anterolateral, anterior and posterior impingement has been extensively described in the orthopaedic literature. The purpose of this article is to review the clinical feature and management of anterior impingement syndrome of the ankle.
Animals ; Ankle ; Ankle Joint ; Athletes ; Humans

PURPOSE: To investigate the effect of fibular malreduction on ankle joint after tibia interlocking IM nailing of tibial and fibular fractures according to type of fibular fractures at preoperation. MATERIALS AND METHODS: Thirty-nine patients who had ipsilateral tibiofibular fracture were analyzed clinically and radiographically. The talocrural angle and the distance from joint line to the tip of fibular were measured on both ankle standing AP view. The difference of angle and distance of both ankle were analyzed by paired t-test and correlation between defference and AOFAS score by Spearman correlation coefficients. RESULTS: The difference of The talocrural angle and the distance from joint line to the tip of fibular of both ankle was statistically significant (p<0.05). The correlation between this difference and AOFAS score was statistically insignificant (p>0.05). CONCLUSION: In tibia interlocking IM nailing of tibia and fibula fracture, malreduction of fibula could cause the change of ankle joint.
Ankle Joint* ; Ankle* ; Fibula ; Humans ; Joints ; Tibia

Osteochondral lesion usually occurs in the elbow, knee and ankle joints. Many articles about osteochondral lesion of the talus in the ankle joint have been reported. We experienced a rare case of partially detached osteochondral lesion of the tibial plafond treated with excision and multiple drilling.
Ankle ; Ankle Joint ; Elbow ; Knee ; Talus

Osteochondroma is the most common of the benign bone tumors. They are probably developmental malformations rather than true neoplasms. But rarely they develope in a joint, especially in the ankle joint. We reported a case of intraarticular osteochondromatosis of ankle joint.
Ankle Joint ; Ankle ; Joints ; Osteochondroma ; Osteochondromatosis

Sixteen legs in eight cadavera were dissected to observe the anatomic course of the superficial peroneal nerve around the ankle and the superficial peroneal sensory conduction study was performed in twenty-eight normal subjects. The anatomic course of the superficial peroneal nerve around the ankle was in two types, type I and type II. Type I was 13 cases(81%) and type II was 3 cases(19%). In type I, the nerve penetrated the crural fascia and became subcutaneous at 8.8+/-1.1 cm proximal to the ankle joint and divided into two major branches at 2.6+/-1.1 cm proximal to the ankle. Medial and intermediate dorsal cutaneous nerves were located at 47%(+/-3.4%) and 35%(+/-4.9%) of the intermalleolar distance from lateral malleolus, respectively. In type II, the medial and intermediate dorsal cutaneous nerve arose seperately from the superficial peroneal nerve at 8.0+/-0.9 cm proximal to the ankle joint. Medial and intermediate dorsal cutaneous nerves were located at 49%(+/-5.6%) and 33%(+/-4.0%) of the intermalleolar distance from the lateral malleolus, respectively. Superficial peroneal sensory conduction study was performed based on the findings of type I. The mean distal latencies and amplitudes were 3.21+/-0.35 msec, 12.1+/-3.37 micronV and 3.17+/-0.37msec, 14.54+/-4.60 micronV in medial and intermediate dorsal cutaneous nerves, respectively.
Ankle ; Ankle Joint ; Fascia ; Leg ; Peroneal Nerve*