Department for Trauma and Orthopedic Surgery, Klinikum Stuttgart, Katharinenhospital, Kriegsbergstr 3, 70563 Stuttgart, Germany.
Knee Surg Sports Traumatol Arthrosc. 2010 May;18(5):664-8. doi: 10.1007/s00167-009-1040-5. Epub 2010 Feb 2.
Ankle joint affections and injuries are common problems in sports traumatology and in the daily routine of arthroscopic surgeons. However, there is little knowledge regarding intraarticular loads. Pressures on the ankle were determined in a dynamic model on 8 cadaver specimens, applying forces to tendons of the foot over the stance phase under vertical loading. A characteristic course of loading in the tibiotalar joint with a rapid increase upon heel contact was observed. It increased gradually to reach a maximum after 70% of the stance phase, during the push-off phase. The major torque in the ankle joint is located anterolaterally. A dynamic loading curve of the ankle joint can be demonstrated. These observations explain phenomena such as the appearance of osteophytes on the anterior tibia in the case of ankle osteoarthritis and the relatively low incidence of posterior tibial edge fragments in the case of trimalleolar ankle fracture. Furthermore, the medial side of the talus is less loaded compared to the lateral side, which appears relevant to the treatment of osteochondrosis dissecans.
踝关节疾病和损伤在运动创伤学和关节镜外科医生的日常工作中都很常见。然而，对于关节内的负荷知之甚少。我们在一个动态模型中对 8 具尸体标本进行了踝关节压力的测试，在垂直负荷下，对足部的肌腱施加力，使其在站立阶段发挥作用。在距骨-跟骨关节中观察到一个具有快速上升的特征性负荷曲线，在跟骨接触后迅速上升。它逐渐增加，在站立阶段的 70%后达到最大值，在蹬离阶段。踝关节的主要扭矩位于前外侧。可以展示踝关节的动态负荷曲线。这些观察结果解释了一些现象，如踝关节骨关节炎中胫骨前侧出现骨赘，三踝骨折中后胫骨缘碎片相对较少的原因。此外，相较于外侧，距骨的内侧受力较小，这与剥脱性骨软骨炎的治疗有关。
