ORIGINAL ARTICLE
A STUDY ON MORPHOMETRY OF ARTICULAR CARTILAGE OF
TIBIOFIBULAR MORTISE
Shishirkumar1, Satheesha Nambiar2, Arunachalam Kumar3, Girish V. Patil4
HOW TO CITE THIS ARTICLE:
Shishirkumar, Satheesha Nambiar, Arunachalam Kumar, Girish V. Patil. “A Study on Morphometry of
Articular Cartilage of Tibiofibular Mortise”. Journal of Evidence Based Medicine and Healthcare; Volume 1,
Issue 7, September 2014; Page: 725-729.
ABSTRACT: Talocrural joint is a major weight bearing joint of the body. The objective of the
study is to find the mean measurements of the articular cartilage of the tibiofibular mortise in
south Indian population, differences between the sides and variations within the same population
and comparison of the study with that of the others. The present study was done in the
Department of Anatomy, K. S. Hegde Medical Academy Mangalore using 11 specimen. All the
measurements were taken using Digital Calipers. There were no significant differences between
the right and the left side. There were no significant differences within the population. Articular
cartilage was wider in front and narrows posteriorly. Its thickness was more in the periphery and
less in the centre. The study will help in the reconstruction surgeries and in the manufacture of
implants in south Indians.
KEYWORDS: Articular, Cartilage Joint, Talocrural, Weight bearing.
INTRODUCTION: The talocrural joint is formed by tibiofibular mortise from above and the talus
below. The tibiofibular mortise is formed by the inclusion of the inferior articular surfaces of tibia
and fibula. The articular cartilage is continuous and thus articular surface of the bones is covered
by the common articular cartilage. So the talocrural joint is a compound joint.
Since man has adjusted himself with bipedalism in the course of evolution the anatomy of
the lower limbs has also changed significantly. The entire body weight is beared by the two lower
limbs in contrast to all the four limbs in the quadrupeds.
Five Sixth of the total weight of the body is taken up by the tibia and the rest of the weight is
taken up by the fibula.[1] Since a lot of load is taken up by the talocrural joint, we can expect a lot
of injuries to happen in the articular cartilages. The injuries of the talocrural joint are also quiet
common. [2] The aim of the present study is to find the morphometry of the cartilage covering the
tibiofibular mortise.
MATERIALS AND METHODS: Altogether 11 formalin fixed ankles were dissected. Out of eleven
specimens 5 belonged to the right and 6 belonged to the left side.
The specimens were dissected which was available in the Department of Anatomy, K. S.
Hegde Medical Academy, Mangalore.
The measurement that were taken on the articulating surface of tibia and fibula are,
medial side length, central length, lateral length, anterior width, central width, posterior width,
medial malleolus (wide width), medial malleolus (narrow width), medial malleolus (height), lateral
malleolus (width), lateral malleolus (height).
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ORIGINAL ARTICLE
Image 1(left): Length measurements of inferior articulating surface of tibia taken at different
levels.
Image 2 (right): Width measurements of inferior articulating surface of tibia taken at different
levels.
Image 3 (left): Measurements of lateral malleolus.
Image 4 (right): Measurements of medial malleolus.
All the Measurements were taken using a thread and digital calipers.
RESULTS: The following results of each and every criterion were noted as below.
Irrespective of the side and sex, the mean values of the length of the tibial plafond on the
medial, central and lateral part are 23 mm, 26.54 mm and 26.18 mm. The mean values of the
width of tibial plafond on the anterior, central and posterior part are 28.81 mm, 26.27 mm, and
21.74 mm.
The mean measurements of wide width, narrow width and the height of the medial
malleolus are 22.54 mm, 11.72 mm and 17 mm.
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On the right side, the mean length measurements are 23 mm, 26.4 mm, and 26mm with
a standard deviation of 1.41 mm, 1.14 mm, and 1 mm. The mean width measurements are 29
mm, 26.4 mm and 21.4 mm.
The mean measurements of the medial malleolus are 22 mm, 11.6 mm and 17.6 mm.
On the left side, the mean width measurements are 23 mm, 26.66 mm, and 26.33 mm.
The mean width measurements are 28.66 mm, 26.16 mm and 21.66 mm.
The mean measurements of medial malleolus are 23 mm, 11.83 mm and 16.5 mm
The mean value of the height of the articulating surface of the lateral malleolus is
19.81mm. The mean value of the breadth of the articulating surface of lateral malleolus is 18.90
mm.
On the right side, the mean height measurement is 19.4 mm. The mean width
measurement is 19 mm.
On the left side, the mean height measurement is 20.16 mm. The mean width
measurement is 18.83 mm.
Tibial Plafond Measurements
Medial length
Central length
Lateral length
Anterior width
Central Width
Posterior Width
Side
R
L
R
L
R
L
R
L
R
L
R
L
Mean
23
23
26.4
26.66
26
26.33
29
28.66
26.4
26.16
21.4
21.66
Std. Deviation
1.41
1.41
1.14
1.03
1
1.75
1.22
1.96
1.51
1.83
1.14
1.75
R
L
R
L
R
L
22
23
11.6
11.83
17.6
16.5
1
1.26
1.14
1.83
1.51
1.64
Sig.
1
0.693
0.716
0.75
0.826
0.777
Medial Malleolus (MM) Measurements
MM (wide width)
MM (Narrow Width)
MM (Height)
0.186
0.811
0.282
Lateral Malleolus (LM) Measurements
R
19
1.41
LM
0.823
Height.
L
18.83
0.98
R
19.4
1.14
LM
0.337
Width.
L
20.16
1.32
Table 1: Table showing the measurements of different criteria taken into consideration
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ORIGINAL ARTICLE
DISCUSSION: The lateral side is lengthier than the other length measurements. The articular
surface is wider in front and narrows posteriorly.
The measurements are similar on both sides.
According to Andrew R. Fauth et al. [3] on the study of anatomical based investigations on
the total ankle arthroplasty.
Irrespective of the sex, the mean values of the length of the tibial plafond on the medial,
central and lateral part are 22.60 mm, 27.72 mm and 26.28 mm.
Irrespective of the sex, the mean values of the width of tibial plafond on the anterior,
central and posterior part are 28.28 mm, 26.96 mm, and 23.56 mm.
Irrespective of the sex, the mean measurements of wide width, narrow width and the
height of the medial malleolus are 11.48 mm, 22.11 mm and 15.81 mm.
Irrespective of sex, the mean value of the height and width of the articulating surface of
the lateral malleolus is 21.99 mm and 20.14mm.
The study is in agreement with that of Adrew. R. Fauth et al.[3]
CONCLUSION: There are slight differences when the data is compared to that of Andrew R
Fauth.[3] This may be because of the fact that, the study conducted in our studies is in “South
Indian West Costal Population”. The difference found in our specimens could be a characteristic
of our population, but no previous studies exist with which to compare our findings. The finding
forms a base for further studies. The measurements are useful to develop ankle prosthesis that
would be specific for south Indian population.
ACKNOWLEDGEMENT: "The present study is based upon the the Dissertation work done by Dr.
Shishirkumar under the guidance of Dr. Satheesha Nambiar. It would be impossible to complete
the work without the help of Dr. Arunachalam Kumar in the Dept. of Anatomy, K.S. Hegde
Medical Academy, Mangalore, Nitte University."
REFERENCES:
1. Lambert KL. The weight bearing function of the fibula. A strain gauge study. J Bone Joint
Surg Am. 1976; 53 (3): 507.
2. Bruce D Beynnon, Darlene F Murphy, Denise M Alosa. Predictive Factors for Lateral Ankle
Sprains. J Athl Train. 2002; 37(4): 376–380.
3. Andrew R Fauth. Anatomically based investigations of total ankle arthroplasty. A thesis in
kinesiology. 2005; doi: etda.libraries.psu.edu/oai/6741.
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ORIGINAL ARTICLE
AUTHORS:
1. Shishirkumar
2. Satheesha Nambiar
3. Arunachalam Kumar
4. Girish V. Patil
PARTICULARS OF CONTRIBUTORS:
1. Assistant Professor, Department of
Anatomy, D. M. Wayanad Institute of
Medical Sciences, Meppadi, Kerala. India.
2. Professor, Department of Anatomy, K. S.
Hegde Medical Academy, Mangalore.
3. Director, R & D, Department of Anatomy,
K. S. Hegde Medical Academy, Mangalore.
4. Associate Professor, Department of
Anatomy, D. M. Wayanad Institute of
Medical Sciences, Meppadi, Kerala. India.
NAME ADDRESS EMAIL ID OF THE
CORRESPONDING AUTHOR:
Dr. Shishirkumar,
Assistant Professor,
Department of Anatomy,
D. M. Wayanad Institute of Medical Sciences,
Meppadi, Kerala. India.
E-mail: dr.shishirnayak1986@yahoo.com
Date
Date
Date
Date
of
of
of
of
Submission: 01/09/2014.
Peer Review: 02/09/2014.
Acceptance: 03/09/2014.
Publishing: 10/09/2014.
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