Revisiting the concept of talar shift in ankle fractures
Revisiting the concept of talar shift in ankle fractures
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DOI：
10.1177/107110070602701006
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发表时间：
2006-10-01
影响因子：
2.7
通讯作者：
Tanaka, Hiro
中科院分区：
文献类型：
--
作者：
Lloyd, John;Elsayed, Sherief;Tanaka, Hiro
背景。 1976 年，拉姆齐和汉密尔顿发表了一项经典实验，研究了简单踝关节骨折模型中距骨移位的生物力学效应。他们的发现是距骨移位 1 毫米会导致胫距接触表面积减少 42%。基于这一结论，距骨移位1mm成为公认的手术固定指征。方法：解剖12具尸体脚踝，在胫骨远端涂上碳粉。将 70 公斤的负载施加到远端胫骨，导致碳转移到距骨上。使用固定在内侧沟槽中的垫片在距骨移位 0、1、2、4 和 6 mm 处确定接触表面积。使用描图纸来标记接触区域的轮廓并使用方格纸进行测量。结果：我们的结果与拉姆齐和汉密尔顿的原始实验相似。距骨横向移位 1 毫米会导致接触表面积减少 40%，而原始实验中为 42%。根据踝关节的形态，距骨接触表面积存在很大差异。结论：拉姆齐和汉密尔顿最初的实验是有效的。
Background. In 1976, Ramsey and Hamilton published a classic experiment investigating the biomechanical effects of talar shift in a simple ankle fracture model. Their finding was that 1 mm of talar shift resulted in a 42% decrease in tibiotalar contact surface area. Based on this conclusion, 1 mm of talar shift became the recognized indication for operative fixation. Methods: Twelve cadaver ankles were dissected and the distal tibia coated with carbon powder. A 70-kg load was applied to the distal tibia that resulted in transference of the carbon onto the talus. The contact surface area was determined at 0, 1, 2, 4 and 6 mm of talar shift using spacers fixed in the medial gutter. Tracing paper was used to mark the outline of the contact area and measured using graph paper. Results: Our results were similar to Ramsey and Hamilton's original experiment. One millimeter of lateral talar shift resulted in 40% loss of contact surface area compared with 42% in the original experiment. A large variance was seen in talar contact surface area depending on the morphology of the ankle joint. Conclusion: Ramsey and Hamilton's original experiment was valid.