Ces radiol. 2009, 63(3):259-265

Radiology of the ankle joint development - some new observationsOriginal article

Tomáš Pešl¹, Petr Havránek¹, Hana Melínová², Lea Havránková²

¹ Klinika dětské chirurgie a traumatologie 3. LF UK a FTN, Praha

² Radiodiagnostické oddělení FTN, Praha

Aim: Plane radiographs of the growing ankle joint were investigated to compare bone age and skeletal development of our cohort with cohorts from the literature review evaluated before twenty five years. The mutual position of the distal fibular physis and the tibiotalar joint space was observed as well.

Methods: One hundred sixty nine radiographs of immature ankle joint for patients ranging from newborns to adolescents without skeletal injury were reviewed. All radiographs were performed for diagnosis of ankle sprain. No patient had neither neurological nor musculoskeletal impairment, nor previous skeletal injury of the ankle joint of the tested extremity or some kind of osteopathy. In the study we evaluated the skeletal development of the ankle and compared the results with results of the studies in the literature review, aged more than twenty years. In the second part of the study we evaluated the vertical position of the distal fibular physis with respect to the plane of the tibiotalar joint space.

Results: In the postnatal skeletal development there was no significant difference contrary to findings of the former studies. In our cohort the physiological cessation of the distal tibial and fibular physis appeared two years earlier than in the former studies, only. Compared to the former studies, dealed with the distal fibular physeal descent, we found, that in one half of cases the distal fibular descent didn't stop in the level of the tibiolatal joint space, but continued more distally.

Conclusion: Postnatal skeletal development of the ankle joint nowadays doesn't differ from the clinical cohorts more than twenty years ago. We found earlier physiological physeal cessation of both distal tibia and fibula. Depending on the mutual position of the distal fibular physis and the tibiotalar joint space we found three radiological types of the growing ankle joint: 1 - distal fibular physis lies above the tibiotalar joint space; 2 - distal fibular physis lies in the level of the tibiotalar joint space; 3 - distal fibular physis lies below the tibiotalar joint space.

Keywords: child, fibula, ankle joint, physis, tibia

Grants and funding:

Studie byla podporována granty IGA MZ ČR reg. č. NR 9132-3/2007, NS 10428-3/2009.

Accepted: April 15, 2009; Published: September 1, 2009  Show citation