Raasch W G, Larkin J J, Draganich L F
Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Illinois 60637.
J Bone Joint Surg Am. 1992 Sep;74(8):1201-6.
We assessed the function of the posterior malleolus, the anterior tibiofibular ligament, and the fibula with regard to posterior stability of the talus in ten ankles of cadavera. Posteriorly directed loads of as much as 200 newtons were applied. Two groups of ankles were tested; in the first group, three ankles in which the ligamentous and osseous structures were intact were tested after transection of the posterior capsule and after removal of 10, 20, 30, and 40 per cent of the articular surface of the distal end of the tibia from the posterolateral corner. In the second group, seven ankles were tested in the same sequence, but the anterior tibiofibular ligament and the fibula were transected before sectioning of the articular surface. Compared with the results for the intact ankle, the experiments on the first group demonstrated less than one millimeter of additional posterior translation of the talus after removal of as much as 40 per cent of the articular surface. In the second group, in which the anterior tibiofibular ligament and the fibula had been transected, significant posterior translation of the talus (more than three millimeters) occurred after removal of 30 per cent of the articular surface (p < 0.01). This represented a 160 per cent increase in translation compared with that in the intact ankle.
我们在十具尸体的脚踝上评估了后踝、胫腓前韧带和腓骨对距骨后稳定性的作用。施加了高达200牛顿的向后负荷。测试了两组脚踝；在第一组中，对三具韧带和骨性结构完整的脚踝进行测试，测试内容包括在后关节囊横断后，以及从后外侧角去除胫骨远端关节面的10%、20%、30%和40%之后的情况。在第二组中，对七具脚踝按相同顺序进行测试，但在关节面切开之前先横断胫腓前韧带和腓骨。与完整脚踝的结果相比，第一组实验表明，在去除高达40%的关节面后，距骨的额外后移小于1毫米。在第二组中，胫腓前韧带和腓骨已被横断，在去除30%的关节面后，距骨出现了明显的后移（超过3毫米）（p<0.01）。与完整脚踝相比，这意味着后移增加了160%。
