Podiatric Resident Physician, PGY-III, Geisinger Community Medical Center, Scranton, PA.
MSME Student, Binghamton University, Binghamton, NY.
J Foot Ankle Surg. 2021 Sep-Oct;60(5):876-880. doi: 10.1053/j.jfas.2020.09.009. Epub 2021 May 26.
Recent literature has proposed that restriction of joints in the rearfoot secondary to coalitions may lead to increased risk for severe ankle fracture after trauma. There is a paucity of literature regarding the rigidity of the ankle joint after arthrodesis of the subtalar and talonavicular joints. In this study, load-to-failure testing of cadaveric ankle joints with and without fusion of the subtalar and talonavicular joints was performed to determine if clinically relevant fracture patterns could be reproduced. Of the 3 fixation patterns studied, combined subtalar and talonavicular joint fusion resulted in a measurable increase in joint stiffness; however, this was not statistically significant. Clinical and radiographic examination postloading revealed that all tested ankle joints sustained a dislocation type injury rather than a specific bone fracture pattern. It was determined that a pure low-speed bending and compression model does not produce clinically relevant fracture patterns, and that higher energy mechanisms are required.
最近的文献表明，由于联合导致的后足关节受限可能会增加创伤后严重踝关节骨折的风险。关于距下关节和跟舟关节融合术后踝关节的刚性，文献很少。在这项研究中，对尸体踝关节进行了加载至失效测试，以确定是否可以复制临床相关的骨折模式，这些踝关节有无距下关节和跟舟关节融合。在研究的 3 种固定方式中，联合距下关节和跟舟关节融合导致关节刚度有可测量的增加，但无统计学意义。加载后的临床和影像学检查显示，所有测试的踝关节都发生了脱位类型的损伤，而不是特定的骨折模式。研究结果表明，纯低速弯曲和压缩模型不会产生临床相关的骨折模式，需要更高能量的机制。
