Influence of Ligament Transection on Tibial and Calcaneal Rotation with Loading and Dorsi-Plantarflexion

1995 ◽  
Vol 16 (9) ◽  
pp. 567-571 ◽  
Author(s):  
Beat Hintermann ◽  
Christian Sommer ◽  
Benno M. Nigg
Keyword(s):  
Internal Rotation ◽  
Axial Loading ◽  
Interosseous Ligament ◽  
Testing Apparatus ◽  
Rotational Movement ◽  
Lateral Ligaments ◽  
Ankle Complex ◽  
Axially Loaded

The purpose of this study was to quantify the effect of sequential ligament transection (anterior talofibular, calcaneofibular, posterior talofibular, deltoid, and subtalar interosseous ligaments) on the rotational movement of the tibia and the calcaneus as associated with axial loading and dorsi-plantarflexing the foot. Eight cadaver foot-leg specimens were investigated using a unconstrained testing apparatus. As the ankle complex was axially loaded, almost the same internal rotation of the tibia and the same calcaneus eversion was found with and without the various degrees of lateral and medial ligament release; additional sectioning of the subtalar interosseous ligament tremendously increased the resulting tibial and calcaneal rotation. While tibial and calcaneal rotation from foot dorsi-plantarflexing did not alter significantly with transection of the lateral ligaments, almost no tibial and calcaneal rotation occurred after additional sectioning of the deltoid and subtalar interosseous ligament. These results indicate that, after release of the lateral ligaments, the foot becomes partially mechanically disconnected from the tibia by additional transection of the medial ligaments and even further disconnected after transection of the subtalar interosseous ligament.

In Vitro Kinematics of the Axially Loaded Ankle Complex in Response to Dorsiflexion and Plantarflexion

1995 ◽  
Vol 16 (8) ◽  
pp. 514-518 ◽  
Author(s):  
Beat Hintermann ◽  
Benno M. Nigg
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Axial Loading ◽  
Testing Apparatus ◽  
Ankle Complex ◽  
Axially Loaded

The rotational movements of the tibia and calcaneus that occur with dorsiflexion-plantarflexion and axial loading were studied in cadaver foot-leg specimens using an unconstrained testing apparatus. Independent of the foot flexion position, significant internal rotation of the tibia and eversion of the calcaneus were noted after the ankle complex was axially loaded. Independent of loading, 10° of dorsiflexion resulted in 0.1° of eversion and 2.1° of internal rotation of the tibia. Conversely, 10° of plantarflexion resulted in 1.6° of inversion and 1.3° of external rotation of the tibia. The induced rotational movements of the tibia and the calcaneus differed significantly between the specimens. These results suggest that the foot “axes” did not change by axially loading the ankle complex and they support previous reports that the ankle complex uses different axes for dorsiflexion and plantarflexion.

Influence of Arthrodeses on Kinematics of the Axially Loaded Ankle Complex during Dorsiflexion/Plantarflexion

1995 ◽  
Vol 16 (10) ◽  
pp. 633-636 ◽  
Author(s):  
Beat Hintermann ◽  
Benno M. Nigg
Keyword(s):  
Ankle Joint ◽  
Tibial Rotation ◽  
Testing Apparatus ◽  
Rotational Movement ◽  
Ankle Complex ◽  
Axially Loaded

The purpose of this study was to quantify the effect of selective arthrodesis (stabilization) of the ankle, subtalar, and talonavicular joints on the rotational movement of the tibia and the calcaneus occurring with dorsiflexion/plantarflexion. Six cadaver foot-leg specimens were investigated using an unconstrained testing apparatus. Simulated ankle joint arthrodesis caused a large increase in tibial rotation and calcaneal eversion-inversion. Subtalar and talonavicular stabilization did not cause as large a rotation.

New Insight Into Energy Harvesting via Axially-Loaded Beams

2009 ◽  
Author(s):  
Mohammed F. Daqaq
Keyword(s):  
Steady State ◽  
Energy Harvesting ◽  
Axial Load ◽  
Excitation Frequency ◽  
Axial Loading ◽  
Response Amplitude ◽  
Resistive Load ◽  
Steady State Response ◽  
State Response ◽  
Axially Loaded

Driven by the study of Leland and Wright [1], this manuscript delves into the qualitative understanding of energy harvesting using axially-loaded beams. Using a simple nonlinear electromechanical model and the method of multiple scales, we study the general nonlinear physics of energy harvesting from a piezoelectric beam subjected to static axial loading and traversal dynamic excitation. We obtain analytical expressions for the steady-state response amplitude, the voltage drop across a resistive load, and the output power. We utilize these expression to study the effect of the axial loading on the overall nonlinear behavior of the harvester. It is demonstrated that, in addition to the ability of tuning the harvester to the excitation frequency via axial load variations, the axial load aids in i) increasing the electric damping in the system thereby enhancing the energy transfer from the beam to the electric load, ii) amplifying the effect of the external excitation on the structure, and hence, increases the steady-state response amplitude and output voltage, and iii) increasing the bandwidth of the harvester by enhancing the effective nonlinearity of the system.

scholarly journals Effect of a Controlled Ankle Motion Walking Boot on Syndesmotic Instability During Weightbearing: A Cadaveric Study

2019 ◽  
Vol 7 (8) ◽  
pp. 232596711986401 ◽  
Author(s):  
Stéphanie Lamer ◽  
Jonah Hébert-Davies ◽  
Vincent Dubé ◽  
Stéphane Leduc ◽  
Émilie Sandman ◽  
...  
Keyword(s):  
External Rotation ◽  
Axial Loading ◽  
Interosseous Ligament ◽  
Ankle Motion ◽  
Paired Samples ◽  
Tibiofibular Ligament ◽  
Custom Made ◽  
Anterior Inferior Tibiofibular Ligament ◽  
Careful Management

Background: Syndesmotic injuries can lead to long-term complications; hence, they require careful management. Conservative treatment is adequate when 1 syndesmotic ligament is injured, but surgery is often necessary to achieve articular congruity when 3 syndesmotic ligaments are ruptured. However, there is some controversy over the best treatment for 2-ligament injuries. Purpose: To evaluate the effect of a controlled ankle motion (CAM) walking boot on syndesmotic instability following iatrogenic isolated anterior inferior tibiofibular ligament (AiTFL) injury and combined AiTFL/interosseous ligament (IOL) injuries in a cadaveric simulated weightbearing model. Study Design: Controlled laboratory study. Methods: Ten cadaveric specimens were dissected to expose the tibial plateau and syndesmosis. The specimens were fitted to a custom-made device, and a reproducible axial load of 750 N was applied. Iatrogenic rupture of the syndesmotic ligaments (AiTFL + IOL) was done sequentially. Uninjured syndesmoses, isolated AiTFL rupture, and combined AiTFL/IOL rupture were compared with and without axial loading (AL) and CAM boot. The distal tibiofibular relationship was evaluated using a previously validated computed tomography scan measurement system. Wilcoxon tests for paired samples and nonparametric data were used. Results: The only difference noted in the distal tibiofibular relationship during AL was an increase in the external rotation of the fibula when using the CAM boot. This was observed with AiTFL rupture (8.40° vs 11.17°; P = .009) and combined AiTFL/IOL rupture (8.81° vs 11.97°; P = .005). Conclusion: AL did not cause a significant displacement between the tibia and fibula, even when 2 ligaments were ruptured. However, the CAM boot produced a significant external rotation with 1 or 2 injured ligaments. Clinical Relevance: Further studies are needed to assess the capacity of the CAM walking boot to prevent malreduction when external rotation forces are applied to the ankle. Moreover, special care should be taken during the fitting of the CAM boot to avoid overinflation of the cushions.

Enhanced Mechanical-Integrity Characterization of Oilwell Annular Sealants Under In-Situ Downhole Conditions

SPE Journal ◽  
2019 ◽  
Vol 24 (05) ◽  
pp. 2308-2319
Author(s):  
Walmy Cuello Jimenez ◽  
Robert Darbe ◽  
Xueyu Pang
Keyword(s):  
Tensile Strength ◽  
Standardized Testing ◽  
Young’S Modulus ◽  
Young's Modulus ◽  
Axial Loading ◽  
Testing Apparatus ◽  
Testing Procedures ◽  
Preliminary Validation ◽  
Three Samples

Summary In this study, we describe an innovative and novel methodology comprising a high–pressure/high–temperature (HP/HT) in–situ–triaxial–testing apparatus for the measurement of sealant mechanical properties (i.e., compressive strength, Young's modulus, and tensile strength) under simulated downhole conditions. The equipment can be used to perform both curing and testing using the same apparatus, thus eliminating depressurization and cooling of test specimens. Additionally, at minimum, three samples can be tested sequentially for statistical analysis and uncertainty mitigation, along with performing real–time monitoring of total HP/HT shrinkage/expansion. The testing apparatus is rated to 30,000 psi for axial loading, 20,000 psi for confining loading, and 400°F. Preliminary validation of Young's modulus was performed with five different plastic samples, yielding error percentages of less than 5% compared to measurements performed using a standardized loading frame. Compressive– and tensile–strength validations were performed using a 16–lbm/gal cement design, and error percentages of less than 2.5 and 7%, respectively, were obtained compared to standardized testing procedures or other studies of the subject. Moreover, a 16–lbm/gal cement system was also used to help assess the functionality of the testing apparatus under simulated wellbore conditions with temperature and pressure ranging from 80 to 350°F and 3,000 to 8,000 psi, respectively.

scholarly journals Effect of CAM boot immobilization on weightbearing stability in syndesmotic injuries

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0030
Author(s):  
Stéphanie Lamer ◽  
Vincent Dube ◽  
Jonah Hebert-Davies ◽  
Leduc Stephane ◽  
Jeremie Menard ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Weight Bearing ◽  
Axial Loading ◽  
Nonoperative Treatment ◽  
Ankle Injuries ◽  
Ligament Injury ◽  
Ankle Motion ◽  
Parametric Data ◽  
Custom Made ◽  
Significant Difference

Category: Trauma Introduction/Purpose: Ankle injuries are one of the most frequent traumas of the lower limb. They typically involve the lower lateral ligaments of the ankle, but the syndesmosis is also affected in up to 18% of cases. The degree of instability of syndesmotic joint depends on which ligaments are affected. Adequate management of syndesmotic injuries is crucial to avoid long term complications. The primary goal of our study was to evaluate the effect of simulated weightbearing on syndesmotic instability resulting from isolated AiTFL injury and from combined AiTFL/IOL injuries. The secondary goal was to evaluate the effect of a controlled ankle motion walking boot on syndesmosis stability following injury. We hypothesized that the CAM boot would prevent significant instability even in two ligaments injuries. Methods: Ten cadaveric specimens were dissected to expose the syndesmosis to create progressive iatrogenic syndesmosis ruptures. Uninjured syndesmoses were compared to isolated AiTFL and combined AiTFL/IOL ruptures. The specimens were fitted in a custom-made device to allow stabilization of the leg and apply a reproducible axial load (AL) of 750 N, equivalent to the weight of a 168-pound person. For each specimen and injury pattern, CT-scan images were obtained with and without AL, and with a CAM boot under AL. Distal tibio-fibular relationship was evaluated in three planes using a previously validated measurement system developed on CT. Wilcoxon tests for paired samples and non-parametric data were done to compare the different conditions. Results: For our first objective, when comparing ankles with isolated AiTFL to combined AiTFL/IOL rupture with and without AL, the only significant difference was an increase in internal rotation between the incisura and a line drawn in the axis of the fibula. Even with minimal statistical differences, it appears that axial loading does not impact syndesmotic stability apart from a slight increase in internal rotation with a single or two-ligament injury. As for our second end point, with the CAM orthopedic boot, no significant widening of the syndesmosis happened when either one or both ligaments were sectioned, in an axial loading state. We therefore confirmed our hypothesis that even with two syndesmotic ligament injuries, axial loading in a CAM boot does not affect distal tibio-fibular anatomy. Conclusion: This study reveals that weight bearing without rotational force does not affect the stability of the syndesmosis. Incomplete syndesmotic injuries can likely be treated with nonoperative treatment in a CAM boot and weight bearing as tolerated. Further clinical studies are needed to confirm these findings.

scholarly journals Is cocontraction a potential cause of tibial internal rotation restriction in patients with knee endoprostheses?

2019 ◽  
Vol 7 (6_suppl4) ◽  
pp. 2325967119S0024
Author(s):  
Christine Suzanne Haberer ◽  
Stefan Weiss ◽  
Igor Komnik ◽  
Sina David
Keyword(s):  
Knee Joint ◽  
Internal Rotation ◽  
Stance Phase ◽  
Knee Prosthesis ◽  
Womac Score ◽  
Subjective Assessment ◽  
Tibial Rotation ◽  
Rotational Movement ◽  
Before And After ◽  
Climbing Stairs

Aims and Objectives: The ischiocrural muscles play an important role in the rotation of the tibia. The main objective of the study was to examine the extent to which an increased cocontraction of the SEMITEN and BIZFEM in patients with bicondylar (TKA) and unicondylar prostheses (UKA) under the influence of everyday forms of stress restricts the tibial rotation. Materials and Methods: 3-D-motion analysis in patients after TKA or UKA was performed to record joint kinematics before and after knee prosthesis. Inclusion criteria: Age 50-70 years, no other prostheses, BMI <31, no relevant diseases, surgery - period 04/2015 to 04/2016. Out of a total of 550 patients finally 22 patients (w:11/m:11) could be included: TKA (n = 11), UKA (n = 9). To imitate various movement patterns of ADL, a parcour was built with a ramp and a staircase with 3 steps. Kinematic data were recorded with 10 infrared 100 Hz cameras. Muscular activities were measured bilaterally with a wireless EMG system (1000 Hz, myon320, muon, CH). Walking speed was collected through a time-gate system (WEKO, Weitmann & Konrad GmbH & Co. KG, DE). Static analysis was performed by statistical nonparametric assignment (SnPM). The WOMAC score was used for subjective assessment of dysfunctions. Results: In normal walking, there was no difference in tibial rotation compared to the non-operated knee in either the TKA or the UKA group. In SnPM analysis, statistically significantly reduced tibial rotation was shown on the downturn of a ramp in the TKA group at the operated knee. The UKA group showed no significant differences on the ramp to the non-operated knee. Concerning co-contraction of the SEMITEN and BIZFEM in the EMG analysis in the operated knee joint, no deviation from the non-operated knee could be shown. When climbing stairs, the SnPM internal rotation analysis revealed significant differences between the TKA and the UKA group (stance phase). Similar to the group comparement a restricted axial rotational movement compared to an operated to non - operated knee joint in the TKA - group could be show.n Especially during the stairway, the knee internal rotation of the prosthesis was impaired compared to the non-operated knee. On the other hand, when climbing stairs, the internal rotation was mostly significantly reduced during the stance phase. The SnPM analysis showed statistically significant asymmetries in the UKA group during stairway walking. The disturbed internal rotational movement showed the UKA group in the operated knee joint compared to the un-operated knee joint to the same extent as the TKA group only during the run down from the ramp. Conclusion: The assumption that cocontractions between the SEMITEN and the BIZFEM contributes to the impairment of internal rotation can not be confirmed from the data available to us. Other influences must be the cause.

The Axial Injury Tolerance of the Human Foot/Ankle Complex and the Effect of Achilles Tension

2002 ◽  
Vol 124 (6) ◽  
pp. 750-757 ◽  
Author(s):  
James R. Funk ◽  
Jeff R. Crandall ◽  
Lisa J. Tourret ◽  
Conor B. MacMahon ◽  
Cameron R. Bass ◽  
...  
Keyword(s):  
Axial Force ◽  
Fracture Mode ◽  
Muscle Tension ◽  
Distal Tibia ◽  
Axial Loading ◽  
Severe Injuries ◽  
Data Set ◽  
Axial Impact ◽  
Survivor Function ◽  
Ankle Complex

Axial loading of the foot/ankle complex is an important injury mechanism in vehicular trauma that is responsible for severe injuries such as calcaneal and tibial pilon fractures. Axial loading may be applied to the leg externally, by the toepan and/or pedals, as well as internally, by active muscle tension applied through the Achilles tendon during pre-impact bracing. The objectives of this study were to investigate the effect of Achilles tension on fracture mode and to empirically model the axial loading tolerance of the foot/ankle complex. Blunt axial impact tests were performed on forty-three (43) isolated lower extremities with and without experimentally simulated Achilles tension. The primary fracture mode was calcaneal fracture in both groups. However, fracture initiated at the distal tibia more frequently with the addition of Achilles tension p<0.05. Acoustic sensors mounted to the bone demonstrated that fracture initiated at the time of peak local axial force. A survival analysis was performed on the injury data set using a Weibull regression model with specimen age, gender, body mass, and peak Achilles tension as predictor variables R2=0.90. A closed-form survivor function was developed to predict the risk of fracture to the foot/ankle complex in terms of axial tibial force. The axial tibial force associated with a 50% risk of injury ranged from 3.7 kN for a 65 year-old 5th percentile female to 8.3 kN for a 45 year-old 50th percentile male, assuming no Achilles tension. The survivor function presented here may be used to estimate the risk of foot/ankle fracture that a blunt axial impact would pose to a human based on the peak tibial axial force measured by an anthropomorphic test device.

scholarly journals Biomechanics of the Distal Tibiofibular Syndesmosis: A Systematic Review of Cadaveric Studies

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110127
Author(s):  
Pranav Khambete ◽  
Ethan Harlow ◽  
Jason Ina ◽  
Shana Miskovsky
Keyword(s):  
Systematic Review ◽  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Stress Test ◽  
Tibiofibular Syndesmosis ◽  
Interosseous Ligament ◽  
Distal Tibiofibular Syndesmosis ◽  
Anatomic Reduction ◽  
Ankle Biomechanics

Background: This investigation’s purpose was to perform a systematic review of the literature examining the biomechanics of the ligaments comprising the distal tibiofibular syndesmosis with specific attention to their resistance to translational and rotational forces. Although current syndesmosis repair techniques can achieve an anatomic reduction, they may not reapproximate native ankle biomechanics, resulting in loss of reduction, joint overconstraint, or lack of external rotation resistance. Armed with a contemporary understanding of individual ligament biomechanics, future operative strategies can target key stabilizing structure(s), translating to a repair better equipped to resist anatomic displacing forces. Study design: Systematic review. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines using a PRISMA checklist. Biomechanical studies testing cadaveric lower limb specimens in the intact and injured state measuring the distal tibiofibular syndesmosis resistance to translational and rotational forces were included in this review. Only studies that included numerical data were included in this review; studies that only reported figures and graphs were excluded. Results: Twelve studies met the inclusion and exclusion criteria. Two studies determined the mechanical properties of syndesmotic ligaments, finding superior strength and stiffness of the interosseous ligament (IOL), as compared to the anterior (AITFL) or posteroinferior tibiofibular ligament (PITFL). Four studies examined native ankle biomechanics establishing physiologic range of motion of the fibula relative to the tibia. Fibular range of motion was found to be up to 2.53 mm of posterior translation (Markolf et al), 1.00 mm lateral translation (Xenos et al), 3.6 degrees of external rotation (Burssens et al), and 1.4 degrees of internal rotation (Clanton et al). Four studies evaluated syndesmotic biomechanics under physiological loading and found that the AITFL, IOL, and PITFL provide the majority of resistance to external rotation, diastasis, and internal rotation, respectively. Two studies investigated the biomechanics of clinically and intraoperatively used tests for syndesmotic injuries and found increased sensitivity of sagittal plane posterior fibular translation, as opposed to coronal plane lateral fibular translation for unstable injuries. Conclusions: Study findings suggest that although the IOL is the strongest syndesmotic ligament, the AITFL has a dominant role stabilizing the distal tibiofibular syndesmosis to external rotation force. Because of these characteristics, operative repair of the AITFL along its native vector may provide a more biomechanically advantageous construct and should be investigated clinically. Additionally, evaluation of clinical stress tests revealed that the external rotation stress test is the most sensitive test to recognize an AITFL tear, and that a 3-ligament disruption is needed to cause diastasis greater than 2 mm.

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