Harper M C
Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37232.
Foot Ankle. 1989 Aug;10(1):36-9. doi: 10.1177/107110078901000107.
A cadaver study was conducted to evaluate the role of the posterior tibial margin or posterior malleolus, as well as medial and lateral supporting structures, in providing posterior stability for the talus. Posterior malleolar fractures consisting of approximately 30%, 40%, and 50% of the articular margin on the lateral radiograph were created in specimens that were then subjected to posterior stressing. No posterior talar subluxation was noted in any specimen. Repeat stressing following removal of the medial malleolus again revealed no subluxation in any specimen. The lateral supporting structures, primarily the posterior fibulotalar and fibulocalcaneal ligaments, appeared to be the key structures providing posterior talar stability. If the fibula is stable in an anatomic position, feared posterior instability of the talus would not appear to be an indication for internal fixation of posterior malleolar fractures.
进行了一项尸体研究，以评估胫骨后缘或后踝以及内侧和外侧支撑结构在为距骨提供后稳定性方面的作用。在标本上制造后踝骨折，其在侧位X线片上分别约占关节边缘的30%、40%和50%，然后对标本施加后向应力。在任何标本中均未发现距骨后脱位。在内踝切除后再次重复施加应力，任何标本中仍未出现脱位。外侧支撑结构，主要是腓骨后距韧带和腓骨跟骨韧带，似乎是提供距骨后稳定性的关键结构。如果腓骨在解剖位置稳定，那么令人担忧的距骨后不稳定似乎不是后踝骨折内固定的指征。
