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外侧韧带损伤后踝关节复合体的关节稳定性特征,第一部分:使用关节测量法的实验室比较

Joint stability characteristics of the ankle complex after lateral ligamentous injury, part I: a laboratory comparison using arthrometric measurement.

作者信息

Kovaleski John E, Heitman Robert J, Gurchiek Larry R, Hollis J M, Liu Wei, Pearsall Albert W

机构信息

Departments of Health, Physical Education, and Leisure Studies, University of South Alabama, Mobile.

出版信息

J Athl Train. 2014 Mar-Apr;49(2):192-7. doi: 10.4085/1062-6050-49.2.07. Epub 2014 Feb 25.

Abstract

CONTEXT

The mechanical property of stiffness may be important to investigating how lateral ankle ligament injury affects the behavior of the viscoelastic properties of the ankle complex. A better understanding of injury effects on tissue elastic characteristics in relation to joint laxity could be obtained from cadaveric study.

OBJECTIVE

To biomechanically determine the laxity and stiffness characteristics of the cadaver ankle complex before and after simulated injury to the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) during anterior drawer and inversion loading.

DESIGN

Cross-sectional study.

SETTING

University research laboratory.

PATIENTS OR OTHER PARTICIPANTS

Seven fresh-frozen cadaver ankle specimens.

INTERVENTION(S): All ankles underwent loading before and after simulated lateral ankle injury using an ankle arthrometer.

MAIN OUTCOME MEASURE(S): The dependent variables were anterior displacement, anterior end-range stiffness, inversion rotation, and inversion end-range stiffness.

RESULTS

Isolated ATFL and combined ATFL and CFL sectioning resulted in increased anterior displacement but not end-range stiffness when compared with the intact ankle. With inversion loading, combined ATFL and CFL sectioning resulted in increased range of motion and decreased end-range stiffness when compared with the intact and ATFL-sectioned ankles.

CONCLUSIONS

The absence of change in anterior end-range stiffness between the intact and ligament-deficient ankles indicated bony and other soft tissues functioned to maintain stiffness after pathologic joint displacement, whereas inversion loading of the CFL-deficient ankle after pathologic joint displacement indicated the ankle complex was less stiff when supported only by the secondary joint structures.

摘要

背景

刚度的力学特性对于研究外侧踝关节韧带损伤如何影响踝关节复合体的粘弹性特性可能很重要。通过尸体研究可以更好地了解损伤对与关节松弛相关的组织弹性特征的影响。

目的

通过生物力学方法确定在尸体踝关节复合体模拟距腓前韧带(ATFL)和跟腓韧带(CFL)损伤前后,在向前抽屉试验和内翻加载过程中的松弛度和刚度特征。

设计

横断面研究。

地点

大学研究实验室。

患者或其他参与者

7个新鲜冷冻的尸体踝关节标本。

干预措施

使用踝关节测角仪对所有踝关节在模拟外侧踝关节损伤前后进行加载。

主要观察指标

因变量为前移、前终末刚度、内翻旋转和内翻终末刚度。

结果

与完整踝关节相比,单独切断ATFL以及联合切断ATFL和CFL均导致前移增加,但终末刚度未增加。在内翻加载时,与完整踝关节和切断ATFL的踝关节相比,联合切断ATFL和CFL导致活动范围增加,终末刚度降低。

结论

完整踝关节和韧带损伤踝关节之间前终末刚度没有变化,表明在病理性关节移位后,骨骼和其他软组织起到维持刚度的作用,而病理性关节移位后CFL损伤的踝关节内翻加载表明,仅由二级关节结构支撑时,踝关节复合体的刚度较低。

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