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The Journal of Bone & Joint Surgery British Volume
Vol. 78-B, Issue 1 | Pages 56 - 60
1 Jan 1996
Ishii T Miyagawa S Fukubayashi T Hayashi K

We investigated a new method of stress radiography of the subtalar joints using forced maximum dorsiflexion of the ankle in a supinated position. We measured transposition of the lateral process of the talus at the posterior subtalar joint in lateral views of normal amputated ankles, normal control subjects and patients with recurrent ankle sprains. The mean displacement in the control groups (n = 36) was 29.9%, significantly different from the 43.0% in patients with recurrent ankle sprains (n = 24).

In the amputated specimens with intact ligaments movement was similar to that in normal subjects. Section of the calcaneofibular and the interosseous ligaments allowed much the same movement as in patients with recurrent ankle sprains.

The new method is simple and useful for detecting subtalar instability.


The Journal of Bone & Joint Surgery British Volume
Vol. 76-B, Issue 5 | Pages 802 - 806
1 Sep 1994
Ishii T Miyagawa S Hayashi K

We report the cases of three children with chronic injuries of the medial tibial malleolus caused by traction injuries during sport. All three had the triad of swelling of the medial malleolus, tenderness over its anterior part, and pain on forced valgus movement of the foot. Radiographs showed bilateral accessory ossification centres and MRI demonstrated partial avulsion or avulsion fracture of the apophyseal cartilage and fragmentation of the accessory centres. A review of 134 young basketball players showed that 25% had tenderness of the anterior medial malleolus. This high rate indicates that traction apophysitis of the medial malleolus is not uncommon in children as a sports-related disorder.