Bertsch C, Rosenbaum D, Claes L
Funktionsbereich Bewegungsanalytik, Klinik und Poliklinik für Allgemeine Orthopädie, Westfälische Wilhelms-Universität Münster, Domagkstrasse 3, 48129 Münster.
Unfallchirurg. 2001 May;104(5):426-33. doi: 10.1007/s001130050754.
Ankle injuries are often followed by degenerative changes in the hindfoot joints. Knowledge about the pressure distribution of the intact ankle joint may help to understand the mechanisms leading to cartilage damage. Therefore, we determined the intraarticular and plantar pressure distribution of the ankle joint complex and the Chopart joints with varying foot positions. 12 human lower leg specimens were axially loaded in a foot-loading simulator with full body weight (600 N). A capacitive pressure distribution platform was used to determine plantar pressure patterns. The intraarticular loading situation was measured with Fuji Prescale film. 3 different foot positions (neutral, 10 degrees dorsiflexion, 10 degrees plantarflexion) were investigated. Dorsiflexion led to an increase of the intraarticular contact area, force and mean pressure in the hindfoot. Plantarflexion instead increased loading in the Chopart joints. In the plantar pressure distribution force and peak pressure under the hindfoot increased with dorsiflexion. With plantarflexion area, force and peak pressure under mid- and forefoot increased. With our study we could demonstrate that the loading situation of the ankle joint complex is significantly influenced by the foot position. These findings may help to understand the development and localisation of arthritic changes due to posttraumatic changes of the joint loading characteristics.
踝关节损伤后常伴有后足关节的退行性改变。了解完整踝关节的压力分布情况可能有助于理解导致软骨损伤的机制。因此,我们测定了不同足部位置时踝关节复合体和Chopart关节的关节内压力分布及足底压力分布。12个人类小腿标本在足部加载模拟器中承受轴向全身重量(600 N)。使用电容式压力分布平台来确定足底压力模式。关节内加载情况用富士预校准薄膜进行测量。研究了3种不同的足部位置(中立位、背屈10度、跖屈10度)。背屈导致后足关节内接触面积、力和平均压力增加。相反,跖屈增加了Chopart关节的负荷。在足底压力分布中,后足下方的力和峰值压力随背屈增加。随着跖屈,中足和前足下方的面积、力和峰值压力增加。通过我们的研究可以证明,足部位置对踝关节复合体的负荷情况有显著影响。这些发现可能有助于理解由于关节负荷特征的创伤后改变而导致的关节炎变化的发展和定位。