¹Assistant Professor, Department of Orthopedics, Nimra Medical College, ibrahimpatnam, Andhra Pradesh-521456. INDIA.

²Assistant professor, Department of Orthopedics, Narayana Medical College, Nellore, Andhra Pradesh-524002. INDIA.

Email: tejatpc@gmail.com

OBSERVATION AND RESULTS

Table 1: In the serum calcium mean value 1.30 (SD±1.4) in Ankle Joint Instability(AJI) patients, 12.1 (SD±1.2) mean value in controlled groups t test value was -14.4 and p value was highly significance(p<0.001).

Table 2: Osseous parameters in radiological study – In the radial range of ankle joint 20.2 mm (SD±2.3) mean value in AJI group. 18.1 mm (SD±1.8) mean value in controlled group t test value was 6.8 and p value was highly significant (p<0.01). In the sector of Ankle joint study 79.2 (SD±4.1) digits in AJI group and 87.3 (SD±6.2) t test value was -10.3 and p value was highly significant (p<0.01). Height of Talus 27.7 (SD±1.9) mean value in AJI group, 26.4 (SD±3.0) mean value in controlled group t test value was 3.4 and p value was significant (p<0.05).

Table 1: Study of Calcium levels in both groups

AJI- Ankle Joint Instability

Figure 1: Study of Calcium levels in both groups

Table 2: Radiological study of ankle in both groups (Osseous Parameters)

AJI- Ankle Joint Instability

Figure 2: Radiological study of ankle in both groups (Osseous Parameters)

DISCUSSION

In the present study of serum calcium levels in relation to Ankle joint instability patients in Andhra Pradesh population. The serum calcium levels mean value in AJI group was 9.30 (SD±1.4) and 12.1 (SD±1.2) in controlled group t test value was -14.4 and p value was highly significant (p<0.001). In the radiological study of osseous parameters – mean value in AJI group was 20.2 (SD±2.3), 18.1 t test value was 6.8 and p value was highly significant (p<0.001), mean value of sector of ankle joint in AJI group was 79.2 (SD±4.1), 87.3 (SD±6.2) in controlled group t value was -10.3 and p value was highly significant (p<0.01), mean value of height of Talus in AJI group was 27.7 (SD±1.9), 26.4 (SD±3.0) in controlled group t test value was 3.4 and p value was significant (p<0.05). These findings were more or less in agreement with previous studies^6,7,8 It is reported that especially nerve and muscle cells do not function properly unless they are bathed in the fluid whose calcium concentration does not fall below or above 11mg calcium per 100cm³. If the concentration in the blood stream tends to fall then calcium is immediately and automatically withdrawn from exchangeable pool in the bones vice-versa. Parathhormone is a powerful hormone and if parathyroid hormone activity is abnormally high, skeleton melts away and its component are lost in urine. Normal growth of bone is dependent on anterior pituitary which stimulates cell division in the cartilaginous growth plates at the end of bones, however it is ineffective in the absence of sufficient thyroxin. The normalcy of content of calcium is influenced not only by age and sex but by economic status, individual total body weight and also possible by physical activity.⁹ Racial differences are taken into account but is very difficult to obtain reliable evidence on this point. Hence it may related to nutritional climatic and other factors¹⁰ Apart from calcium vitamin A also controls activity, distribution and co-ordination of the osteoblastic and osteoclastic activity to the sites where it is normally found and the reaction is often of very intense nature. Hence dietary supplement contains calcium (Vitamin D), Vitamin A, also play vital role in the joint stability. Risk of spraining of ankle joint depends on both intrinsic factors like hind foot alignment, laxity of ligaments, muscular co-ordination, neuro-muscular control and extrinsic factors involve shoe worn type and intensity of sports, warm-up etc.¹¹ but rapid recovery depends on normalcy in bone mineralization and vascularity.

SUMMARY AND CONCLUSION

Ankle joint is one of the main weight bearing of body hence it needs lot of factors to stabilize its proper functioning. Calcium is proved to be one of the main mineral to maintain the density of the bones of ankle joint but this study further demands nutritional genetic hormonal, embryological, patho-physiological study because exact factors which determine the time of ossification are still obscure.

This research paper was approved by ethical committee of Nimra Medical College, Jupudi-521456. Andhra Pradesh

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