Department of Orthopedics, Yildirim Beyazit University, Faculty of Medicine, Ataturk Training and Research Hospital, Ankara, Turkey.
Department of Anatomy, Ankara University, School of Medicine, Ankara, Turkey.
Foot Ankle Surg. 2014 Jun;20(2):125-9. doi: 10.1016/j.fas.2014.01.004. Epub 2014 Jan 31.
The fibula is known not to involve in transmission of weight but known simply as an ankle stabilizer. However, its main function in stabilizing the ankle remains obscure. Since the fibula has an impact on torsion and rotation of the ankle, its effect on lateral ankle instability should be investigated.
Twenty patients with lateral ankle instability (Group 1) and 19 healthy volunteers (Group 2) were included in the study. The tibiofibular and talofibular relationships were evaluated using MRI images. Fibular torsion and rotation angles were calculated using a new method. Range of motion of the ankle joint was investigated while the knee was at flexion (90°) and extension (0°). The comparisons performed between the 2 groups and independent from the groups were statistically evaluated and, the p value of <0.05 was considered as statistically significant.
A significant difference was found between the two groups for age (p<0.05). There were no statistically significant differences between the right and left sides for all measurements in the group 1 and 2 (p>0.05). There was a statistically significant difference between the two groups in dorsal flexion when the knee is at flexion (90°) and extension (0°) position. There was also a statistically significant difference between the two groups in plantar flexion which was measured while the knee was at extension (0°) position. No statistically significant difference was found between both groups in terms of fibular torsion and rotation. However, independent from the groups when the patients were divided into 2 groups according to whether the fibula localized posteriorly or not, in patients with posteriorly localized fibula it was demonstrated that the fibular torsion and rotation was increased significantly.
We did not detect any relationship between fibular torsion and rotation and ankle instability. However, independent from the groups when the patients were divided into 2 groups according to whether the fibula localized posteriorly or not, we realized that in patients with posteriorly localized fibula, fibular torsion and rotation significantly increased. This finding did not explain the cause of instability. However, it may gain significance with new further studies regarding ankle instability.
腓骨不参与承重，仅作为踝关节稳定器。然而，其稳定踝关节的主要功能尚不清楚。由于腓骨会影响踝关节的扭转和旋转，因此应该研究其对踝关节外侧不稳定的影响。
本研究纳入了 20 例外侧踝关节不稳定患者（第 1 组）和 19 名健康志愿者（第 2 组）。使用 MRI 图像评估胫腓骨和距腓骨的关系。使用新方法计算腓骨扭转和旋转角度。在膝关节屈曲（90°）和伸展（0°）时，研究踝关节的活动范围。对 2 组之间的比较以及独立于组之间的比较进行了统计学评估，p 值<0.05 被认为具有统计学意义。
两组之间的年龄存在显著差异（p<0.05）。第 1 组和第 2 组的左右两侧在所有测量值上均无统计学差异（p>0.05）。在膝关节屈曲（90°）和伸展（0°）时，背屈时两组之间存在统计学显著差异。在膝关节伸展（0°）时，跖屈时两组之间也存在统计学显著差异。两组之间在腓骨扭转和旋转方面无统计学差异。然而，独立于组之间，当根据腓骨是否位于后方将患者分为两组时，发现腓骨位于后方的患者腓骨扭转和旋转明显增加。
我们没有发现腓骨扭转和旋转与踝关节不稳定之间存在任何关系。然而，独立于组之间，当根据腓骨是否位于后方将患者分为两组时，我们发现腓骨位于后方的患者腓骨扭转和旋转明显增加。这一发现并不能解释不稳定的原因。然而，随着关于踝关节不稳定的新的进一步研究，它可能会获得意义。
