The effect of Achilles tendon lengthening on ankle dorsiflexion: A cadaver study
The effect of Achilles tendon lengthening on ankle dorsiflexion: A cadaver study
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DOI：
10.1177/107110070602700605
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发表时间：
2006-06-01
影响因子：
2.7
通讯作者：
Tucker, K
中科院分区：
文献类型：
--
作者：
Costa, ML;Logan, K;Tucker, K
背景：跟腱延长是跟腱断裂后并发症的重要原因。然而，直接测量肌腱长度是困难的。因此，踝关节背屈被用作替代测量，假设是跟腱限制了这一运动。本研究的目的是评估跟腱长度与踝关节背伸之间的关系。主要的问题是跟腱是否是限制脚踝背屈的结构。第二个目的是量化跟腱延长和踝关节背屈之间的关系。方法：解剖5具身体标本，显露小腿和后足的肌腱和包膜组织。固定的骨参考点作为测量的标志。在第一个标本中，跟腱是完整的，其他可能限制踝关节背屈的结构被顺序分割。其余标本每隔1 cm延长跟腱1 cm，记录对踝关节背屈运动的影响。结果：分离其他肌腱和踝关节周围的关节囊组织不影响踝关节背屈的范围。当跟腱分开时，脚可以背屈，直到距骨颈撞击胫骨远端的前部。肌腱长度每增加一厘米，背屈平均增加12度。结论：跟腱是限制踝关节背屈的解剖结构，即使在延长的情况下也是如此。在该身体模型中，跟腱的长度与踝关节背屈的范围之间存在线性关系。踝关节背伸似乎是临床上有用的肌腱长度指标。
Background: Tendon lengthening is an important cause of morbidity after Achilles tendon rupture. However, direct measurement of the tendon length is difficult. Ankle dorsiflexion has, therefore, been used as a surrogate measure on the assumption that it is the Achilles tendon that limits this movement. The aim of this investigation was to assess the relationship between Achilles tendon length and ankle dorsillexion. The primary question was whether or not the Achilles tendon is the structure that limits ankle dorsiflexion. The secondary purpose was to quantify the relationship between Achilles tendon lengthening and dorsiflexion at the ankle joint. Methods: Five cadaver specimens were dissected to expose the tendons and capsular tissue of the leg and hindfoot. Fixed bony reference points were used as markers for the measurements. In the first specimen, the Achilles tendon was intact and the other structures that may limit ankle dorsiflexion were sequentially divided. In the other specimens the Achilles tendon was lengthened by 1 cm intervals and the effect upon ankle dorsiflexion movement was recorded. Results: Division of the other tendons and the capsular tissue around the ankle joint did not affect the range of ankle dorsiflexion. When the Achilles was divided the foot could be dorsiflexed until the talar neck impinged upon the anterior aspect of the distal tibia. There was a mean increase of 12 degrees of dorsiflexion for each centimeter increase in tendon length. Conclusion: The Achilles tendon is the anatomical structure that limits ankle dorsiflexion, even when the tendon is lengthened. There was a linear relationship between the length of the Achilles tendon and the range of ankle dorsiflexion in this cadaver model. Ankle dorsillexion would appear to be a clinically useful indicator of tendon length.