Lateral tibiotalar distance

Last revised by Henry Knipe on 2 Feb 2022

Lateral tibiotalar distance is a measurement on an ankle anterior drawer lateral view to assess for ankle instability


On an ankle anterior drawer lateral view (typically performed using a Telos device 2-4), the distance between the posterior tip of the distal tibial articular surface and the nearest lateral talar articular surface is measured 1-3.


  • >10 mm difference in pre-stress and post-stress views is indicative of instability 3
    • >5 mm difference with contralateral ankle is also suggestive of instability 3
  • >8 mm: suggestive of posterior talofibular 2 or calcaneofibular ligament injury 1
  • >5 mm: suggestive of anterior instability (anterior talofibular ligament injury) 4

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