Ankle Stability Assessment for Surgical Intervention

Radiographic Evaluation

• The American College of Radiology recommends obtaining standard radiographs, including AP, lateral, and mortise views, as the initial step in evaluating ankle stability 1
• Gravity stress views are more reliable and easier to perform than manual stress views for evaluating supination-external rotation injuries, according to the American College of Radiology 1
• Weight-bearing radiographs, if possible, provide additional information about fracture stability, as suggested by the American College of Radiology 1
• A difference in measurements between standard mortise and gravity stress views can indicate instability, with the American College of Radiology recommending a threshold of >2 mm 1
• Increased incidence of instability is associated with certain clinical findings, including medial tenderness, bruising, swelling, fibular fracture above the syndesmosis, bi/trimalleolar fractures, open fracture, or high-energy injury, as reported by the American College of Radiology 1