Dorsiflexion is more feasible than plantar flexion in ultrasound evaluation of the calcaneofibular ligament: a combination study of ultrasound and cadaver
Dorsiflexion is more feasible than plantar flexion in ultrasound evaluation of the calcaneofibular ligament: a combination study of ultrasound and cadaver
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DOI：
10.1007/s00167-019-05630-z
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发表时间：
2020-01-01
影响因子：
3.8
通讯作者：
Akita, Keiichi
中科院分区：
文献类型：
--
作者：
Hattori, Soichi;Nimura, Akimoto;Akita, Keiichi
目的超声(US)是评价踝关节慢性外侧不稳定的有价值的工具，但超声评价跟腓韧带(CFL)的可行性尚不清楚。本研究的目的是描述和比较不同踝关节位置超声下的CFL，以确定评估CFL的最佳方法，并用身体标本来解释US的结果。方法这项美国研究包括25名健康人的43个脚踝。分别在足底屈曲20°、中立位、背屈20°和最大背屈时用US扫描CFL。比较腓骨与CFL之间的距离。身体研究包括7个踝关节CFL动态变化的宏观定性观察和17个踝关节CFL和足印方向的定量观察。结果在美国的研究中，在足底屈曲20度时，腓骨到CFL的平均距离(Mm)为7.3+/-1.3，在中立位为6.7+/-1.6，在背屈20度时为4.3+/-2.5，在最大背屈时为3.1+/-2.1。踝关节背屈程度越高，腓骨与CFL之间的距离越短(JUNKHEER‘s趋势检验P<；0.001)。在身体研究中，CFL纤维在最大背屈时平行于中间物质和腓骨附着物之间排列，而CFL在足底屈曲时被反射和旋转。结论CFL的全长，包括其腓骨附着点，在背屈时比在足底屈位更容易显示，这是由于CFL在腓骨附着点的方向与最大背屈时的中间物质平行所致。
Purpose Ultrasound (US) is a valuable tool for the evaluation of chronic lateral instability of the ankle; however, the feasibility of US for calcaneofibular ligament (CFL) assessment remains unknown. This study aimed to depict and compare CFL on US in various ankle positions to determine the optimal method for evaluating CFL with US and to interpret US findings using cadaveric specimens. Methods The US study included 43 ankles of 25 healthy individuals. The CFL was scanned with US in 20 degrees plantar flexion, neutral position, 20 degrees dorsiflexion and maximum dorsiflexion. The distances between fibula and CFL were compared. The cadaveric study included macroscopic qualitative observation of the dynamic change of CFL in 7 ankles and quantitative observation of the directions of CFL and footprints in 17 ankles. Results In the US study, the mean distance (mm) between fibula and CFL was 7.3 +/- 1.3 in 20 degrees plantar flexion, 6.7 +/- 1.6 in neutral position, 4.3 +/- 2.5 in 20 degrees dorsiflexion and 3.1 +/- 2.1 in maximum dorsiflexion. The more dorsiflexed the ankle was, the shorter the distance between fibula and CFL was (Jonckheere's trend test p < 0.001). In the cadaveric study, the CFL fibres were aligned parallel between the mid-substance and the fibular attachment in maximum dorsiflexion, whilst CFL was reflected and rotated in plantar flexion. Conclusions The whole length of the CFL, including its fibular attachment, is more likely to be visualized with US in dorsiflexion than in plantar flexion due to the direction of the CFL at the fibular attachment, which is parallel with the mid-substance in maximum dorsiflexion.