Ankle Joint Pressure in Supination-External Rotation Injuries: A Biomechanical Study in an Unrestrained Cadaver Model.

Autor:	Fösel AC; Department of Orthopaedic Surgery and Traumatology, Inselspital, University of Berne, Berne, Switzerland (AS, MCA, FGK).; AO-Research Institute Davos, Switzerland (IZ, BG).; Department of Orthopaedic Surgery and Traumatology, Bürgerspital Solothurn, Solothurn, Switzerland (ACF)., Seidel A; Department of Orthopaedic Surgery and Traumatology, Inselspital, University of Berne, Berne, Switzerland (AS, MCA, FGK).; AO-Research Institute Davos, Switzerland (IZ, BG).; Department of Orthopaedic Surgery and Traumatology, Bürgerspital Solothurn, Solothurn, Switzerland (ACF)., Attinger MC; Department of Orthopaedic Surgery and Traumatology, Inselspital, University of Berne, Berne, Switzerland (AS, MCA, FGK).; AO-Research Institute Davos, Switzerland (IZ, BG).; Department of Orthopaedic Surgery and Traumatology, Bürgerspital Solothurn, Solothurn, Switzerland (ACF)., Zderic I; Department of Orthopaedic Surgery and Traumatology, Inselspital, University of Berne, Berne, Switzerland (AS, MCA, FGK).; AO-Research Institute Davos, Switzerland (IZ, BG).; Department of Orthopaedic Surgery and Traumatology, Bürgerspital Solothurn, Solothurn, Switzerland (ACF)., Gueorguiev B; Department of Orthopaedic Surgery and Traumatology, Inselspital, University of Berne, Berne, Switzerland (AS, MCA, FGK).; AO-Research Institute Davos, Switzerland (IZ, BG).; Department of Orthopaedic Surgery and Traumatology, Bürgerspital Solothurn, Solothurn, Switzerland (ACF)., Krause FG; Department of Orthopaedic Surgery and Traumatology, Inselspital, University of Berne, Berne, Switzerland (AS, MCA, FGK).; AO-Research Institute Davos, Switzerland (IZ, BG).; Department of Orthopaedic Surgery and Traumatology, Bürgerspital Solothurn, Solothurn, Switzerland (ACF).
Jazyk:	angličtina
Zdroj:	Foot & ankle specialist [Foot Ankle Spec] 2022 Aug; Vol. 15 (4), pp. 330-337. Date of Electronic Publication: 2020 Sep 02.
DOI:	10.1177/1938640020950183
Abstrakt:	Background: Previous biomechanical studies simulating supination-external rotation (SER) IV injuries revealed different alterations in contact area and peak pressure. We investigated joint reaction forces and radiographic parameters in an unrestrained, more physiological setup. Methods: Twelve lower leg specimens were destabilized stepwise by osteotomy of the fibula (SER II) and transection of the superficial (SER IVa) and the deep deltoid ligament (SER IVb) according to the Lauge-Hansen classification. Sensors in the ankle joint recorded tibio-talar pressure changes with axial loading at 700 N in neutral position, 10° of dorsiflexion, and 20° of plantarflexion. Radiographs were taken for each step. Results: Three of 12 specimen collapsed during SER IVb. In the neutral position, the peak pressure and contact area changed insignificantly from 2.6 ± 0.5 mPa (baseline) to 3.0 ± 1.4 mPa (SER IVb) ( P = .35) and from 810 ± 42 mm 2 to 735 ± 27 mm 2 ( P = .08), respectively. The corresponding medial clear space (MCS) increased significantly from 2.5 ± 0.4 mm (baseline) to 3.9 ± 1.1 mm (SER IVb) ( P = .028).The position of the ankle joint had a decisive effect on contact area ( P = .00), center of force ( P = .00) and MCS ( P = .01). Conclusion: Simulated SER IVb injuries demonstrated radiological, but no biomechanical changes. This should be considered for surgical decision making based on MCS width on weightbearing radiographs. Levels of Evidence: Not applicable. Biomechanical study.
Databáze:	MEDLINE
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