The ankle plays an important role in walking and running, connecting the leg to the foot. The ankle and subtalar joints have extraordinarily complex anatomies and biomechanical functions that allow extreme loading, complex three-dimensional motion, and balancing. During walking and running, and especially during sports activities, the two joints must react quickly to an enormous input of information from the rest of the body.
Most “malformations” of the ankle occur in combination with other, mostly congenital, deformities such as fibular hemimelia or proximal congenital femoral deficiency (CFD). These severe forms usually require reconstructive surgery.
Injuries and Trauma
The ankle and subtalar joints are sensitive to injuries and trauma. Ankle sprains are common, and although usually limited to soft tissue and ligamentous injuries, they often take a long time to achieve full recovery. Physical therapy and specific strengthening and balancing exercises can help to speed up recovery and prevent future injuries.
Fractures at the ankle joint often include the growth plate. If the growth plate partially closes after trauma, shortening and malalignment can occur.
Valgus Position of the Ankle
Deformities involving only the ankles are rare. Valgus position of the ankle is a deformity found at the tibia (shin bone), where it forms the joint line of the ankle. This joint line is inclined in ankle valgus instead of being horizontal. This can lead to an inclination of the heel, which mimics a flat foot position of the heel. Ankle valgus is sometimes combined with genu valgum (knock-knees). If the growth plate at the ankle is intact, ankle valgus can be corrected using guided growth with a small plate and two screws, similar to the correction of knock-knees.