TRABECULAR TRAUMA OF THE TALUS AND MEDIAL MALLEOLUS CONCURRENT WITH LATERAL COLLATERAL LIGAMENTOUS INJURIES OF THE ANKLE - EVALUATION WITH MR-IMAGING

Objective. The objective of this study was to elucidate the relationsh ip between lateral collateral ligamentous injuries of the ankle (ankle sprain) and bone bruise (trabecular trauma) of the talus and/or malle oli in the patients with twisting injuries of the ankle. Design. Magne tic resonance studies of the ankle were retrospectively reviewed, focu sing on the presence or absence of lateral collateral ligamentous inju ries and the location of bone bruise in the talus and/or malleoli. Pat ients. Thirty-five patients with acute twisting injuries of the ankle were studied. Results and conclusion. Four patterns of bone bruise wer e found in 14 patients: (1) bone bruise in the talar dome equivalent t o osteochondral fracture in two patients, (2) bone bruise in the poste romedial aspect of the talus and the medial malleolus singly or in com bination in four, (3) bone bruise in the anteromedial aspect of the ta lus in six, and (4) bone bruise with a combination of the second and t hird patterns in two. The second pttern was associated with tear of th e anterior talofibular (ATAF) ligament in all patients and injury of t he calcaneofibular (CF) ligament in one out of four. The third and fou rth patterns were associated with tears of both ATAF and CF ligaments in all patients. The identification of bone bruise was of value in ind icating lateral collateral ligamentous injuries.