0:00

So if we in fact look at the typical AP radiograph

0:06

of of an ankle, there are certain things that can help us.

0:10

The degree of overlap between the tibia

0:13

and fibula shown here generally is greater

0:16

than six millimeters.

0:18

The medial clear space typically shown here is less than

0:22

three millimeters, and the medial

0:24

and horizontal clear spaces are approximately normal.

0:28

So those are quick things you can look at

0:31

to judge the integrity of the ankle mortis.

0:34

If we go ahead, in fact, look at an an abnormal situation,

0:38

we can see, in fact in this example, there is widening

0:42

of the medial clear space.

0:44

There is not the normal degree of overlap between the tibia

0:48

and fibula indicating a problem here

0:51

with a syndesmotic ligament injury.

0:53

And we can, of course see a supra syndesmotic fracture

0:57

of the distal fibula.

1:00

Let's look now at a mortis view where again,

1:02

we have certain measurements that may help us.

1:05

Typically, the lateral clear space is somewhat ver

1:09

variable on the mortis view, generally less than two,

1:12

but is high, less than five and a half millimeters.

1:15

The overlap here between tibia

1:18

and fibula should be greater than one millimeter.

1:21

It would be in this region, the medial clear space,

1:26

not shown in the radiograph,

1:27

but this medial clear space generally is less

1:30

than four millimeters.

1:31

And then another measurement that can be done

1:34

with a line involving the posterior aspect

1:37

of the tibia is called the tibial fibular clear space.

1:41

And typically it's less than six millimeters.

1:45

So to look at an abnormal mortis view, I show you this view

1:48

with clearly widening of the medial clear space.

1:52

There is in fact little overlap at all here

1:57

between the tibia

1:58

and fibula with an Aly wide tibial fibular clear space.

2:02

And in this particular example,

2:04

we can see a supra syndesmotic fracture of the ankle.