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Wheeless' Textbook of Orthopaedics
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Radiographs for Ankle Fractures


- See: Radiographic Studies of the Foot and Ankle


- Lateral of Ankle:



- Mortise Views:
     - syndesmotic injury;
     - medial clear space should be less than 4 mm and superior- medial joint space w/ in 2 mm medially of its width laterally;
            - due to the obliquity of the medial malleolus, measurement of medial clear space can be difficult on the Mortise view (in this case use AP view);
     - talar tilt
     - tibiofibular line
     - talocrural angle

- AP
     - medial clear space should be less than 4 mm and superior-medial joint  space w/ in 2 mm medially of its width laterally;
            - often, it is easier to measure medial clear space on AP view rather than mortise view due to obliquity of  medial mortise;
     - space between medial wall of fibula & incisural surface of tibia < 5 mm
     - anterior tubercle of tibia should overlap fibula by atleast 10 mm;
     - second method is to draw a line down the center of the tibia, & thru center of the talar dome on both the AP and lateral x-ray;
            - mortise width is usually 4 mm;





Experimentally produced ankle fractures in autopsy specimens.

The key role of the lateral malleolus in displaced fractures of the ankle.

Examination of the pathologic anatomy of ankle fractures.

Ankle fractures. A clinical and roentgenographic stereophotogrammetric study.

Radiographic Measurement of the Distal Tibiofibular Syndesmosis Has Limited Use.


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Original Text by Clifford R. Wheeless, III, MD.