RECONSTRUCTION OF THE LATERAL ANKLE LIGAMENTS - A BIOMECHANICAL ANALYSIS
RECONSTRUCTION OF THE LATERAL ANKLE LIGAMENTS - A BIOMECHANICAL ANALYSIS
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DOI：
10.1177/036354659202000518
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发表时间：
1992-09-01
影响因子：
4.8
通讯作者：
ZARINS, B
中科院分区：
文献类型：
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作者：
COLVILLE, MR;MARDER, RA;ZARINS, B
本研究的目的是对用于稳定外侧踝关节的几种常用手术程序进行生物力学分析。我们在15个尸体踝关节上进行了Evans、Watson-Jones和Chrisman-Snook手术，并测试了踝关节的稳定性、运动和移植物放置的等距性。与韧带完整的踝关节相比，Evans手术增加了距骨的前移位、内旋和倾斜。距下关节活动受限于Evans手术。Watson-Jones手术控制了距骨的内旋和前移位，但在控制距骨倾斜方面效果较差，并且限制了距下关节的运动。与韧带完整的踝关节相比，Chrisman-Snook手术允许增加距骨的内旋和前移位。该程序是有效的，在限制距骨倾斜，但限制距下jointmotion.Based上获得的生物力学数据，我们设计了一种外侧踝关节重建与骨隧道，再现前距腓和跟腓韧带的解剖方向。这种踝关节韧带重建抵抗前移位，内旋，和距骨倾斜，而不限制距下关节motion.Clinical relevance：我们发现相当大的机械差异更常见的进行外侧踝关节重建。可以定位骨隧道和移植物放置，从而实现更解剖的配置。
The purpose of this study was to perform a biomechanical analysis of several commonly performed operative procedures used to stabilize the lateral ankle. We performed the Evans, Watson-Jones, and Chrisman-Snook procedures on 15 cadaveric ankles and tested the ankles for stability, motion, and isometry of graft placement. The Evans procedure allowed increased anterior displacement, internal rotation, and tilt of the talus when compared to ankles with intact ligaments. Subtalar joint motion was restricted by the Evans procedure. The Watson-Jones procedure controlled internal rotation and anterior displacement of the talus, but was less effective in controlling talar tilt and also restricted subtalar joint motion. The Chrisman-Snook procedure allowed increased internal rotation and anterior displacement of the talus when compared to ankles with intact ligaments. The procedure was effective in limiting talar tilt, but restricted subtalar joint motion.Based on the biomechanical data obtained, we devised a lateral ankle reconstruction with bone tunnels that reproduce the anatomic orientation of both the anterior talofibular and calcaneofibular ligaments. This ankle ligament reconstruction resists anterior displacement, internal rotation, and talar tilt without restricting subtalar joint motion.Clinical relevance: We found considerable mechanical differences among the more commonly performed lateral ankle reconstructions. It is possible to locate bone tunnels and graft placement so that a more anatomic configuration is achieved.