正常距腓前韧带和跟腓韧带的应变模式及采用大收肌腱重建后的变化：尸体研究。
Strain patterns in normal anterior talofibular and calcaneofibular ligaments and after anatomical reconstruction using gracilis tendon grafts: A cadaver study.
机构信息
Clinical and Research Institute for Foot and Ankle Surgery, 341-1, Mangoku, Kisarazu, Chiba, 292-0003, Japan.
Department of Orthopaedic Surgery, Lions Gate Hospital, North Vancouver, BC, Canada.
出版信息
BMC Musculoskelet Disord. 2021 Jun 18;22(1):558. doi: 10.1186/s12891-021-04444-w.
BACKGROUND
Inversion ankle sprains, or lateral ankle sprains, often result in symptomatic lateral ankle instability, and some patients need lateral ankle ligament reconstruction to reduce pain, improve function, and prevent subsequent injuries. Although anatomically reconstructed ligaments should behave in a biomechanically normal manner, previous studies have not measured the strain patterns of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) after anatomical reconstruction. This study aimed to measure the strain patterns of normal and reconstructed ATFL and CFLs using the miniaturization ligament performance probe (MLPP) system.
METHODS
The MLPP was sutured into the ligamentous bands of the ATFLs and CTLs of three freshly frozen cadaveric lower-extremity specimens. Each ankle was manually moved from 15° dorsiflexion to 30° plantar flexion, and a 1.2-N m force was applied to the ankle and subtalar joint complex.
RESULTS
The normal and reconstructed ATFLs exhibited maximal strain (100) during supination in three-dimensional motion. Although the normal ATFLs were not strained during pronation, the reconstructed ATFLs demonstrated relative strain values of 16-36. During the axial motion, the normal ATFLs started to gradually tense at 0° plantar flexion, with the strain increasing as the plantar flexion angle increased, to a maximal value (100) at 30° plantar flexion; the reconstructed ATFLs showed similar strain patterns. Further, the normal CFLs exhibited maximal strain (100) during plantar flexion-abduction and relative strain values of 30-52 during dorsiflexion in three-dimensional motion. The reconstructed CFLs exhibited the most strain during dorsiflexion-adduction and demonstrated relative strain values of 29-62 during plantar flexion-abduction. During the axial motion, the normal CFLs started to gradually tense at 20° plantar flexion and 5° dorsiflexion.
CONCLUSION
Our results showed that the strain patterns of reconstructed ATFLs and CFLs are not similar to those of normal ATFLs and CFLs.
背景
内翻型踝关节扭伤，即外踝扭伤，常导致症状性外侧踝关节不稳定，部分患者需要进行外侧踝关节韧带重建以减轻疼痛、改善功能并预防后续损伤。虽然解剖重建的韧带在生物力学上应该表现正常，但之前的研究并未测量解剖重建后距腓前韧带（ATFL）和跟腓韧带（CFL）的应变模式。本研究旨在使用微型化韧带性能探头（MLPP）系统测量正常和重建的 ATFL 和 CFL 的应变模式。
方法
将 MLPP 缝合到三个新鲜冷冻尸体下肢标本的 ATFL 和 CTL 韧带束中。每个踝关节从 15°背屈到 30°跖屈，踝关节和距下关节复合体施加 1.2-N·m 的力。
结果
正常和重建的 ATFL 在三维运动中在旋后位表现出最大应变（100）。虽然正常的 ATFL 在旋前位不受力，但重建的 ATFL 表现出相对应变值为 16-36。在轴向运动中，正常的 ATFL 从 0°跖屈开始逐渐紧张，随着跖屈角度的增加，应变增加，在 30°跖屈时达到最大值（100）；重建的 ATFL 表现出相似的应变模式。此外，正常的 CFL 在三维运动中在跖屈-外展时表现出最大应变（100），在背屈时表现出相对应变值 30-52。重建的 CFL 在背屈-内收时表现出最大应变，在跖屈-外展时表现出相对应变值 29-62。在轴向运动中，正常的 CFL 从 20°跖屈和 5°背屈开始逐渐紧张。
结论
我们的结果表明，重建的 ATFL 和 CFL 的应变模式与正常的 ATFL 和 CFL 不同。
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