The Effect of Damage to the Lateral Collateral Ligaments on the Mechanical Characteristics of the Ankle Joint—An In-Vitro Study

1990 ◽  
Vol 112 (2) ◽  
pp. 129-137 ◽  
Author(s):  
S. Siegler ◽  
Jie Chen ◽  
C. D. Schneck
Keyword(s):  
Ankle Joint ◽  
Diagnostic Procedure ◽  
Mechanical Characteristics ◽  
Three Dimensional ◽  
Lower Limbs ◽  
Anterior Talofibular Ligament ◽  
Collateral Ligaments ◽  
Ligament Injuries ◽  
Calcaneofibular Ligament ◽  
Lateral Collateral Ligaments

Injuries to the lateral collateral ligaments of the ankle joint are among the most frequently occurring injuries at the lower limb. The present study was conducted for the purpose of establishing the basis for the development of a quantitative diagnostic procedure for such injuries. To achieve this goal, the effect of four types of ligament injuries on the three-dimensional mechanical characteristics of the ankle were investigated. These types of injuries consisted of: 1) isolated tear of the anterior talofibular ligament; 2) isolated tear of the calcaneofibular ligament; 3) isolated tear of the posterior talofibular ligament; and 4) combined tear of both the anterior talofibular ligament and the calcaneofibular ligament. The experiments were conducted on 31 amputated lower limbs and consisted of comparing the three-dimensional load-displacement and flexibility characteristics of the ankle joint prior to and following sectioning of selected ligaments. The experimental and analytical procedures used to derive these characteristics was developed previously by the authors [3, 24]. From the results of this study it was concluded that the three-dimensional flexibility characteristics of the ankle joint are strongly influenced by damage to the lateral collateral ligaments. Furthermore, it was found that each type of ligament injury produced unique and identifiably changes in the flexibility characteristics of the ankle. These unique changes, which are described in detail in this paper, can be used to discriminate between the different types of ligament injuries. Consequently, it was concluded that it is feasible to develop a quantitative diagnostic procedure for ankle ligament injuries based on the effect of the injury on the flexibility characteristics of the ankle.

The Mechanical Characteristics of the Collateral Ligaments of the Human Ankle Joint

Foot & Ankle ◽  
1988 ◽  
Vol 8 (5) ◽  
pp. 234-242 ◽  
Author(s):  
Sorin Siegler ◽  
John Block ◽  
Carson D. Schneck
Keyword(s):  
Mechanical Properties ◽  
Ankle Joint ◽  
Mechanical Characteristics ◽  
Ultimate Load ◽  
Lower Limbs ◽  
High Yield ◽  
Collateral Ligaments ◽  
Ankle Ligaments ◽  
Orthopaedic Literature ◽  
Human Ankle

In the present study, the tensile mechanical properties of all of the collateral ligaments of the human ankle joint were determined, in vitro, from tensile tests conducted on 120 ligaments obtained from 20 fresh lower limbs. The ultimate load of the lateral collateral ligaments increased in an anteroposterior sequence, with the anterior fibulotalar ligament less than the fibulocalcaneal ligament and less than the posterior fibulotalar ligament. For the medial collateral ligaments, the increasing order of ultimate load was found to be tibiocalcaneal ligament, tibionavicular ligament, tibiospring ligament, posterior tibiotalar ligament. The posterior tibiotalar ligament and tibiospring ligament, so frequently neglected in the anatomical and orthopaedic literature, demonstrated the highest yield force and ultimate load of all of the collateral ligaments of the ankle. Additionally, the tibiospring ligament showed high yield and ultimate elongation properties probably related to its distal attachment to the spring ligament. The fibulocalcaneal ligament was found to have high linear elastic modulus suggesting some type of unique material properties or internal fiber organization. Knowledge of the mechanical characteristics of the ligaments of the ankle joint contributes to an understanding of their normal function, pathomechanics of injury, and their optimal surgical reparative procedure and reconstructive material. A knowledge of the normal mechanical properties of the ankle ligaments provides a data base to evaluate which of the multiplicity of present tendon graft materials has mechanical properties similar to those of the ligaments to be replaced. Those tendon grafts will be the most suitable for replacement of specific ligaments. Finally, data on the mechanical properties of these ligaments offer the possibility for evaluating any future biological or prosthetic grafts.

scholarly journals The Benefits of the Plastination Techniques for the Anatomo Clinical Studies of Ankle Joint Ligaments Injuries

2017 ◽  
Vol 54 (3) ◽  
pp. 487-490
Author(s):  
Alina Maria Sisu ◽  
Gheorghe Noditi ◽  
Dan Grigorescu ◽  
Sorin Floresc ◽  
Jenel Marian Patrascu ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Deltoid Ligament ◽  
Anterior Talofibular Ligament ◽  
Ligament Injuries ◽  
Calcaneofibular Ligament ◽  
Conventional Mri ◽  
Ankle Ligament ◽  
Ct And Mri ◽  
Second Degree

The present research was made by following three directions: dissection and plastination, clinical ankle joint ligament injuries and MRI and CT examination of the cases.191 cases of ankle joint ligament injuries have been studied during two years. They were examined clinically and radiologically, using CT and MRI testing. The classification of ankle sprain was based on the number of injured ligaments. Out of the 191 cases diagnosed with ligament injuries, 92 involved the anterior talofibular ligament, 54 in the calcaneofibular ligament, 40 involved the posterior talofibular ligament and 5 involved the deltoid ligament. First degree sprain involves the injury of the anterior talofibular ligament, the second degree sprain involves the injury of the anterior talofibular ligament and of the calcaneofibular ligament, and the third degree sprain involves the damaging of anterior and posterior talofibular ligaments, as well as the calcaneofibular ligament. In this paper we have diagnosed a number of 39 first degree springs, 12 of second degree springs and 41 of third degree springs. The standard X- ray examinations have a low diagnostic rate of the ankle ligament injuries. Conventional MRI has a higher accuracy in diagnosing ankle joint collateral ligaments lesions.

Lateral Ankle Instability as a Cause of Superior Peroneal Retinacular Laxity: An Anatomic and Biomechanical Study of Cadaveric Feet

Foot & Ankle ◽  
1993 ◽  
Vol 14 (6) ◽  
pp. 330-334 ◽  
Author(s):  
Mark J. Geppert ◽  
Mark Sobel ◽  
Walther H.O. Bohne
Keyword(s):  
Ankle Instability ◽  
Biomechanical Study ◽  
Peroneal Tendon ◽  
Collateral Ligaments ◽  
Calcaneofibular Ligament ◽  
Lateral Ankle ◽  
Ankle Inversion ◽  
Tendon Reflex ◽  
Lateral Ankle Instability ◽  
Lateral Collateral Ligaments

The role of the competent superior peroneal retinaculum (SPR) as a primary restraint to peroneal tendon subluxation and mechanical attritional wear is clear. Injury to the SPR has classically been described as a dorsiflexion aversion movement of the ankle coupled with a forceful peroneal tendon reflex contraction. This mechanism, however, does not cause injury to the lateral collateral ligaments of the ankle and does not explain the coexistent findings of lateral ankle instability, laxity of the SPR, and concurrent peroneal tendon pathology. Anatomic studies reveal a parallel alignment of the calcaneal band of the SPR and the calcaneofibular ligament. A cadaveric model of ankle instability created by serial sectioning of the lateral collateral ligaments revealed increasing visual strain on the SPR with increasing degrees of ankle instability. These findings suggest the SPR serves as a secondary restraint to ankle inversion stress and that the force or forces that result in chronic ankle instability can also injure and attenuate the superior peroneal retinaculum.

Comparative study of the anatomy, CT and MR images of the lateral collateral ligaments of the ankle joint

2008 ◽  
Vol 30 (4) ◽  
pp. 361-367 ◽  
Author(s):  
Jia Hua ◽  
Jian Rong Xu ◽  
Hai Yan Gu ◽  
Wei Li Wang ◽  
Wen Jin Wang ◽  
...  
Keyword(s):  
Comparative Study ◽  
Ankle Joint ◽  
Collateral Ligaments ◽  
Mr Images ◽  
Lateral Collateral Ligaments

scholarly journals Bioengineering. Dynamic Evaluation of the Contact Characteristics and Three-Dimensional Motion for the Ankle Joint with Lateral Ligament Injuries.

2001 ◽  
Vol 44 (4) ◽  
pp. 1082-1088 ◽  
Author(s):  
Kensaku KAWAKAMI ◽  
Go OMORI ◽  
Shojiro TERASHIMA ◽  
Makoto SAKAMOTO ◽  
Toshiaki HARA
Keyword(s):  
Ankle Joint ◽  
Three Dimensional ◽  
Lateral Ligament ◽  
Ligament Injuries ◽  
Dynamic Evaluation

scholarly journals Deep-Learning-Based MRI Images for Analysis of Sport-Induced Ankle Joint Injury

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Wenbo Zhang
Keyword(s):  
Neural Network ◽  
Ankle Joint ◽  
Good Prognosis ◽  
Anterior Talofibular Ligament ◽  
Calcaneofibular Ligament ◽  
Joint Injury ◽  
The Neural Network ◽  
Number Of Patients ◽  
Magnetic Resonance Imaging Mri ◽  
Grade Iii

This study was to analyze the sport-induced ankle joint injury (AJI) images based on the neural network algorithms using the magnetic resonance imaging (MRI). 20 patients and 20 volunteers were included in the experimental and control groups, respectively. The hybrid diffusion equation (HDE) neural network (HDENN) algorithm was compared with the fully convolutional neural network (FCNN) and the FCNN preprocessing, and the HDE was applied to the MRI analysis of sport-induced AJI. The results showed that the total score of MRI image for the conventional position of the anterior talofibular ligament (ATFL) and posterior talofibular ligament (PTFL) was concentrated in 4 (55%) and 5 (65%), respectively. The number of patients with good prognosis with grade II injury (11 cases) was much higher than that of grade III injury (2 cases), and the number of patients with poor prognosis (4 cases) was lower than that of grade III injury (6 cases) ( P < 0.05 ). Conventional MRI was recommended to observe the ATFL and PTFL, and the valgus position MRI was recommended for the calcaneofibular ligament (CFL); conservative treatment was recommended for patients with grades I and II AJI, but surgical treatment was recommended for patients with grade III AJI.

The Role of Calcaneofibular Ligament Injury in Ankle Instability: Implications for Surgical Management

2018 ◽  
Vol 47 (2) ◽  
pp. 431-437 ◽  
Author(s):  
Kenneth J. Hunt ◽  
Helder Pereira ◽  
Judas Kelley ◽  
Nicholas Anderson ◽  
Richard Fuld ◽  
...  
Keyword(s):  
Contact Mechanics ◽  
Ankle Joint ◽  
Contact Area ◽  
Ankle Instability ◽  
Peak Torque ◽  
Ligament Injury ◽  
Lateral Ligament ◽  
Anterior Talofibular Ligament ◽  
Ankle Sprains ◽  
Calcaneofibular Ligament

Background: Acute inversion ankle sprains are among the most common musculoskeletal injuries. Higher grade sprains, including anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) injury, can be particularly challenging. The precise effect of CFL injury on ankle instability is unclear. Hypothesis: CFL injury will result in decreased stiffness, decreased peak torque, and increased talar and calcaneal motion and will alter ankle contact mechanics when compared with the uninjured ankle and the ATFL-only injured ankle in a cadaveric model. Study Design: Descriptive laboratory study. Methods: Ten matched pairs of cadaver specimens with a pressure sensor in the ankle joint and motion trackers on the fibula, talus, and calcaneus were mounted on a material testing system with 20° of ankle plantarflexion and 15° of internal rotation. Intact specimens were axially loaded to body weight and then underwent inversion along the anatomic axis of the ankle from 0° to 20°. The ATFL and CFL were sequentially sectioned and underwent inversion testing for each condition. Linear mixed models were used to determine significance for stiffness, peak torque, peak pressure, contact area, and inversion angles of the talus and calcaneus relative to the fibula across the 3 conditions. Results: Stiffness and peak torque did not significantly decrease after sectioning of the ATFL but decreased significantly after sectioning of the CFL. Peak pressures in the tibiotalar joint decreased and mean contact area increased significantly after CFL release. Significantly more inversion of the talus and calcaneus as well as calcaneal medial displacement was seen with weightbearing inversion after sectioning of the CFL. Conclusion: The CFL contributes considerably to lateral ankle instability. Higher grade sprains that include CFL injury result in significant decreases in rotation stiffness and peak torque, substantial alteration of contact mechanics at the ankle joint, increased inversion of the talus and calcaneus, and increased medial displacement of the calcaneus. Clinical Relevance: Repair of an injured CFL should be considered during lateral ligament reconstruction, and there may be a role for early repair in high-grade injuries to avoid intermediate and long-term consequences of a loose or incompetent CFL.

scholarly journals Anatomic Measurement and Variability Analysis of the Anterior Talofibular Ligament and Calcaneofibular Ligament of the Ankle

2021 ◽  
Vol 9 (11) ◽  
pp. 232596712110472
Author(s):  
Han Yang ◽  
Minghao Su ◽  
Zhimin Chen ◽  
Rongmei Qu ◽  
Zhirong Yuan ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Coefficient Of Variation ◽  
Articular Surface ◽  
Lateral Collateral Ligament ◽  
Anatomic Reconstruction ◽  
Anterior Talofibular Ligament ◽  
Calcaneofibular Ligament ◽  
Tissue Quality ◽  
Length Width ◽  
Lateral Ankle Ligaments

Background: The anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) contribute greatly to the overall stability of the ankle joint; however, ATFL and combined ATFL-CFL sprains are common. Anatomic reconstruction of the lateral collateral ligament with grafts has been proposed for patients with poor tissue quality or inadequate local tissue. Anatomic reconstruction of the lateral ankle ligaments requires a good understanding of their anatomic location. Purpose: To describe the anatomy of the ATFL and CFL ligaments quantitatively and qualitatively and explore the relationship of some morphological parameters. Study Design: Descriptive laboratory study. Methods: A total of 66 adult ankle specimens were analyzed for ATFL band type, origin, length, width, thickness, and angle between the ATFL and CFL, and 73 adult ankle specimens were used for measuring the origin of the CFL. The coefficient of variation was used to describe and compare the respective variability of angle, length, width, and thickness. The origin of the ATFL was labeled as point A, and the leading edge of the CFL intersection with the articular surface of the calcaneus was considered point B. Results: The ATFL had a variable number of bands. A high degree of variability (coefficient of variation >0.2) was seen for most morphological measurements of the ATFL. In addition, the length of distance AB also varied. The CFL originated at the tip of the fibula in only 9% of specimens. It was found more commonly at the anterior border of the lateral malleolus (4.94 ± 1.70 mm from the tip). The angle between the ATFL and CFL was consistent at 100° to 105º. Conclusion: A fair amount of variability of ATFL length, width, and thickness were found in our study, with less variability in the ATFL-CFL angle. Most CFLs attached anterior to the tip of the fibula. Clinical Relevance: Providing relevant anatomic data of ATFL and CFL is important in ensuring proper surgical treatment of ankle joint injuries.

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