Department of Orthopaedic Surgery, Kantonsspital Liestal, CH-4410 Liestal, Switzerland.
Foot Ankle Int. 2011 Jun;32(6):609-15. doi: 10.3113/FAI.2011.0609.
Distal tibia coronal plane malalignment predisposes the ankle joint to asymmetric load. The purpose of this cadaveric study was to quantify changes in pressure and force transfer in an ankle with a supramalleolar deformity.
Seventeen cadaveric lower legs were loaded with 700 N after creating supramalleolar varus and valgus deformities. The fibula was left intact in 11 specimens and osteotomized in six. Tekscan© sensors were used to measure the tibiotalar pressure characteristics.
In isolated supramalleolar deformity, the center of force and peak pressure moved in an anteromedial direction for valgus and posterolateral direction for varus deformities. The change was in an anteromedial direction for varus and in a posterolateral direction for valgus deformities in specimens with an osteotomized fibula.
Two essentially different groups of varus and valgus deformities of the ankle joint need to be distinguished. The first group is an isolated frontal plane deformity and the second group is a frontal plane deformity with associated incongruency of the ankle mortise.
Our findings underline the complexity of asymmetric osteoarthritis of the ankle joint. In addition, results from this study provide useful information for future basic research on coronal plane deformity of the hindfoot and for determining appropriate surgical approaches.
胫骨远端冠状面对线不良使踝关节容易承受不对称的负荷。本尸体研究的目的是定量测量踝上畸形对踝关节压力和力传递的影响。
在 17 个尸体小腿上施加 700N 的载荷后，分别造成踝上内翻和外翻畸形。11 个标本保留腓骨完整，6 个标本行腓骨截骨。Tekscan©传感器用于测量胫距关节的压力特征。
在单纯踝上畸形中，力中心和峰值压力在外翻时向前后内侧移动，在内翻时向前后外侧移动。腓骨截骨的标本中，畸形向前后内侧方向变化，外翻畸形向前后外侧方向变化。
需要区分两种不同的踝关节内翻和外翻畸形。第一组为单纯额状面畸形，第二组为踝穴不匹配的额状面畸形。
我们的发现强调了踝关节不对称性骨关节炎的复杂性。此外，本研究结果为后续跟骨额状面畸形的基础研究以及确定合适的手术方法提供了有用的信息。
