Osseous ankle morphology and recurrent lateral sprains: A case-control study

Background. This study evaluated the relationship between intrinsic osseous ankle morphological characteristics and recurrent lateral ankle sprain history. Methods. Fifty-two patients with recurrent lateral ankle sprain history were age-and sex-matched with 46 healthy control group subjects. Standardized anterior-posterior and lateral ankle-foot radiographs were taken and morphometric tibial arc length (TiAL), ankle stability angle (γ), sagittal tibial mortise radius (SRTi), trochlea tali length (TaAL), talar tenon height (h), sagittal radius of the trochlea tali arc (SRTa), tibiotalar sector (a), and talar height (H) measurements were performed by an independent radiologist. Step-wise multiple regression, receiver operator characteristics (ROC) and area under the curve (AOC) analyses helped to determine clinical decision-making efficacy. Results. SRTi:SRTa and TaAL:TiAL ratios displayed strong efficacy for clinical decision-making. The AOC for the SRTi:SRTa ratio was 0.95 (95% confidence interval of 0.93-1.0). For the SRTi:SRTa ratio, a value of 0.68 produced a sensitivity of 0.96 and a specificity of 0.85. The AOC for the TaAL:TiAL ratio was 0.97 (95% confidence interval of 0.89-1.0). For the TaAL: TiAL ratio, a value of 1.15 produced a sensitivity of 0.98 and a specificity of 0.91. Conclusions. SRTi:SRTa and TaAL:TiAL ratio intrinsic osseous ankle morphological characteristics were related to recurrent lateral ankle sprain history providing excellent sensitivity and good specificity. Intrinsic osseous ankle morphological characteristics can help guide doctors and surgeons as they make treatment decisions for patients with recurrent lateral ankle sprain injuries.