Wülker N, Stukenborg C, Savory K M, Alfke D
Orthopaedic Department, Hannover Medical School, Germany.
Foot Ankle Int. 2000 Nov;21(11):921-7. doi: 10.1177/107110070002101106.
Passive motions at the subtalar joint, talonavicular joint and calcaneocuboid joint were measured in eight ankle specimens, using an ultrasonic motion analysis system. Arthrodeses of the three joints were performed in all feasible combinations and the resulting motion change at the unfused joints was determined. Motion at the subtalar joint was not significantly affected by fusion of the calcaneocuboid joint, reduced to one quarter by fusion of the talonavicular and calcaneocuboid joints (double arthrodesis) and almost completely eliminated with all other fusions. Motion at the talonavicular joint was not significantly affected by calcaneocuboid fusion and reduced to approximately one third with the subtalar and the double arthrodesis. Motion at the calcaneocuboid joint was not significantly reduced by subtalar fusion but almost completely eliminated in all fusions involving the talonavicular joint. It is concluded that the talonavicular joint is the key articulation for hindfoot motion. Double arthrodesis preserved significant motion at the subtalar joint. Fusion of the calcaneocuboid joint had no significant influence on remaining hindfoot motion.
使用超声运动分析系统,对八个踝关节标本的距下关节、距舟关节和跟骰关节进行了被动运动测量。对这三个关节进行了所有可行组合的关节融合术,并确定了未融合关节的运动变化。跟骰关节融合对距下关节的运动没有显著影响,距舟关节和跟骰关节融合(双关节融合术)使距下关节运动减少至四分之一,而其他所有融合术几乎完全消除了距下关节的运动。跟骰关节融合对距舟关节的运动没有显著影响,距下关节融合和双关节融合术使距舟关节运动减少至约三分之一。距下关节融合对跟骰关节的运动没有显著减少,但在所有涉及距舟关节的融合术中几乎完全消除了跟骰关节的运动。结论是距舟关节是后足运动的关键关节。双关节融合术保留了距下关节的显著运动。跟骰关节融合对剩余后足运动没有显著影响。