X RAY LEFT ANKLE MORTISE VIEW

The mortise view of the ankle is an AP radiographic projection with the foot internally rotated about 15–20° to align the tibia and fibula and open the ankle mortise. It clearly images the distal tibia, fibula and talus plus the tibio‑fibular syndesmosis, allowing assessment of joint space, talar shift, fractures and syndesmotic or ligamentous injury.

Position the patient supine or seated with the knee extended and the foot dorsiflexed to 90°. Internally rotate the entire leg 15–20° so the intermalleolar line is parallel to the image receptor. Center the x‑ray beam on the ankle joint (midway between malleoli) and include distal tibia/fibula and talus. Collimate appropriately; obtain weight‑bearing views for instability.

The ankle mortise is the bony socket formed by the distal tibia (plafond) and the medial and lateral malleoli of tibia and fibula that houses the talus. It creates a stable hinge joint allowing dorsiflexion and plantarflexion. Proper mortise alignment is essential for load transfer; widening or disruption—seen after fractures or syndesmotic injuries—causes instability and altered ankle mechanics.

The standard three views for an ankle radiograph are anteroposterior (AP), lateral, and mortise. The AP shows tibia, fibula and talus alignment; the lateral demonstrates the tibial plafond, talar dome and calcaneus in profile; the mortise is an internally rotated AP (about 15–20°) that opens the ankle joint space to better assess congruity and subtle fractures.

A mortise in medical terms is a socket-like anatomical space that receives a corresponding bone process to form a joint. Commonly used for the ankle mortise — the tibial plafond and distal fibula forming a socket for the talus — it’s important for joint stability and is assessed on imaging (mortise view) to detect malalignment, syndesmotic injury, and fractures.

A Maisonneuve fracture is caused by a forceful external-rotation injury of the ankle. The rotational force ruptures the ankle syndesmosis and interosseous membrane, transmitting energy up the leg and producing a proximal fibular fracture. It is commonly associated with medial malleolus fracture or deltoid ligament rupture and typically occurs during high‑energy events such as sports injuries, falls, or traffic accidents.