The ankle (talocrural) joint is a mortise-and-tenon synovial hinge joint formed by the tibia (plafond and medial malleolus), fibula (lateral malleolus), and talar dome. The bony mortise constrains the talus in dorsiflexion but relies on ligaments for stability in plantarflexion. The joint axis is not purely horizontal — it is inclined 6 degrees inferolaterally, explaining the coupled eversion with dorsiflexion.
Ankle fractures are classified by the Weber/Danis system based on fibular fracture level relative to the syndesmosis. Lateral ankle sprains (ATFL, CFL) are the most common musculoskeletal injury. Ankle arthritis from post-traumatic, rheumatoid, or primary OA is managed by fusion (arthrodesis) or total ankle replacement. Ankle arthroscopy accesses both anterior (ATFL, talofibular recess, plafond) and posterior (posterior impingement, FHL) compartments. The anterior ankle joint line is 1 cm below the tip of the medial malleolus — the reference for anteromedial arthroscopic portal placement.
Plantarflexion-inversion tearing the ATFL — the most common musculoskeletal sport injury.
Malleolar fractures from rotation classified by Weber system — stability determines operative versus conservative management.
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