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踝关节支具对外侧踝关节扭伤三维运动学及胫距关节接触状况的影响。

The effect of an ankle brace on the 3-dimensional kinematics and tibio-talar contact condition for lateral ankle sprains.

作者信息

Omori Go, Kawakami Kensaku, Sakamoto Makoto, Hara Toshiaki, Koga Yoshio

机构信息

Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, 950-8518 Niigata, Japan.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2004 Sep;12(5):457-62. doi: 10.1007/s00167-004-0493-9. Epub 2004 Mar 18.

Abstract

Ten fresh-frozen cadaveric ankles were studied to investigate the effect of an ankle brace (Air-Stirrup) on the three-dimensional (3-D) motion and contact-pressure distribution of the talo-tibial joint with lateral ligamentous injury. Three-dimensional motion and contact-pressure distribution were simultaneously measured under dynamic conditions employing a direct linear-transformation technique and a dynamic-pressure sensor, respectively. Inversion increased significantly upon severing of the anterior talo-fibular (ATF) ligament and calcaneo-fibular (CF) ligaments; however, restoration to the intact level was observed following application of the ankle brace. Internal rotation also increased upon severing of the lateral ligaments in the plantar flexion; however, this difference was not altered by using the ankle brace. The contact area on the articular surface of the talus shifted from posterior to anterior between plantar flexion and dorsal flexion; additionally, a high pressure area was evident in the medial aspect of the talus following severing of the lateral ligaments. Upon application of the ankle brace, however, no significant changes were apparent in the contact condition. The results of this study suggest that stabilization against inversion is the major function of braces in terms of protection of ankle sprains. Ankle sprains, however, often occur in combinations of inversion, plantar flexion and internal rotation; therefore, restriction of plantar flexion and internal rotation may also be an important function of the ankle brace.

摘要

研究了10个新鲜冷冻的尸体踝关节,以探讨踝关节支具(Air-Stirrup)对伴有外侧韧带损伤的距胫关节三维(3-D)运动和接触压力分布的影响。分别采用直接线性变换技术和动态压力传感器,在动态条件下同时测量三维运动和接触压力分布。切断距腓前韧带(ATF)和跟腓韧带(CF)后,内翻明显增加;然而,应用踝关节支具后观察到恢复到完整水平。在跖屈时切断外侧韧带后,内旋也增加;然而,使用踝关节支具并没有改变这种差异。距骨关节面的接触面积在跖屈和背屈之间从后向前移动;此外,切断外侧韧带后,距骨内侧出现高压区。然而,应用踝关节支具后,接触情况没有明显变化。本研究结果表明,就保护踝关节扭伤而言,防止内翻的稳定作用是支具的主要功能。然而,踝关节扭伤常发生在内翻、跖屈和内旋的组合中;因此,限制跖屈和内旋也可能是踝关节支具的重要功能。

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