Kjaersgaard-Andersen P, Madsen F, Frich L H, Wethelund J O, Søjbjerg J O
Biomechanics Laboratory, Orthopaedic Hospital, University of Aarhus, Denmark.
J Foot Surg. 1990 Jan-Feb;29(1):25-32.
The stabilizing effect of the Evans tenodesis on movements in the tibiotalocalcaneal joint complex was studied in 10 amputation specimens, using a kinesiologic testing device. The tenodesis was tested following solitary lesion of the anterior talofibular ligament and after combined lesions of the anterior talofibular and calcaneofibular ligaments. All tenodeses were performed with the joint complex in the neutral position. Regardless of the extent of ligamentous damage, the tenodesis frequently restricted adduction and internal rotation to a level below that recorded at intact ligaments. Instability in external rotation in the joint complex and anteroposterior laxity of the talus were never completely reconstructed, regardless of what degree of flexion in the joint complex the tenodeses were tested. The study demonstrates that, if performed with the tibiotalocalcaneal joint complex in the neutral position, the Evans tenodesis cannot reconstruct normal hindfoot kinematics, irrespective of the extent of ligamentous damage. However, severe instability in adduction and internal rotation, both part of clinical supination, were effectively prevented by the tenodesis.
使用运动学测试装置，在10个截肢标本上研究了埃文斯肌腱固定术对胫距跟关节复合体运动的稳定作用。在单独损伤距腓前韧带后以及距腓前韧带和跟腓韧带联合损伤后对肌腱固定术进行测试。所有肌腱固定术均在关节复合体处于中立位时进行。无论韧带损伤程度如何，肌腱固定术常常将内收和内旋限制在低于完整韧带记录水平。无论在关节复合体何种屈曲度下测试肌腱固定术，关节复合体的外旋不稳定和距骨的前后松弛都从未完全重建。该研究表明，如果在胫距跟关节复合体处于中立位时进行埃文斯肌腱固定术，无论韧带损伤程度如何，都无法重建正常的后足运动学。然而，肌腱固定术有效预防了内收和内旋的严重不稳定，这两者都是临床旋后畸形的一部分。
