Orthopaedic Biomechanics Laboratories, Michigan State University, East Lansing, Michigan, USA.
J Orthop Res. 2012 Sep;30(9):1423-9. doi: 10.1002/jor.22085. Epub 2012 Feb 10.
While high ankle sprains are often clinically ascribed to excessive external foot rotation, no experimental study documents isolated anterior tibiofibular ligament (ATiFL) injury under this loading. We hypothesized that external rotation of a highly everted foot would generate ATiFL injury, in contrast to deltoid ligament injury from external rotation of a neutral foot. Twelve (six pairs) male cadaveric lower extremity limbs underwent external foot rotation until gross failure. All limbs were positioned in 20° of dorsiflexion and restrained with elastic athletic tape. Right limbs were in neutral while left limbs were everted 20°. Talus motion relative to the tibia was measured using motion capture. Rotation at failure for everted limbs (46.8 ± 6.1°) was significantly greater than for neutral limbs (37.7 ± 5.4°). Everted limbs showed ATiFL injury only, while neutral limbs mostly demonstrated deltoid ligament failure. This is the first biomechanical study to produce isolated ATiFL injury under external foot rotation. Eversion of the axially loaded foot predisposes the ATiFL to injury, forming a basis for high ankle sprain. The study helps clarify a mechanism of high ankle sprain and may heighten clinical awareness of isolated ATiFL injury in cases of foot eversion prior to external rotation. It may also provide guidance to investigate the effect of prophylactic measures for this injury.
虽然高踝关节扭伤通常归因于过度的足部外旋，但没有实验研究记录在这种负载下单独的前胫腓韧带（ATiFL）损伤。我们假设，高度外翻的足部外旋会导致 ATiFL 损伤，而不是中立足部外旋导致三角韧带损伤。12 个（6 对）男性尸体下肢进行了足部外旋，直到出现明显的失败。所有肢体均置于背屈 20°，并用弹性运动胶带固定。右侧肢体中立，而左侧肢体外翻 20°。使用运动捕捉测量距骨相对于胫骨的运动。外翻肢体的失效旋转角度（46.8±6.1°）明显大于中立肢体（37.7±5.4°）。外翻肢体仅显示 ATiFL 损伤，而中立肢体主要显示三角韧带失败。这是第一个在外旋足部产生单独 ATiFL 损伤的生物力学研究。轴向负荷足的外翻使 ATiFL 易于受伤，为高踝关节扭伤形成基础。该研究有助于阐明高踝关节扭伤的机制，并可能提高临床对足外翻后外旋时单独 ATiFL 损伤的认识。它还可以为研究这种损伤的预防措施提供指导。
