Parlasca R, Shoji H, D'Ambrosia R D
Clin Orthop Relat Res. 1979 May(140):266-72.
Using 10 normal fresh cadaveric legs, kinematic effects of ligamentous injuries around the ankle joint were studied while the ankle joint moved from maximum plantar flexion to maximum dorsiflexion in saggittal plane. A series of anteroposterior and lateral sequential roentgenograms was taken both in the normal and subsequently created injured condition, to evaluate instant center of rotation and horizontal rotation pattern in the hindfoot complex. Although the pattern of instant center of rotation of the ankle joint varied among normal condition, the majority fell in a prescribed area. The deviation of instant centers from those in uninjured condition was most evident in lateral ligament injury. The average horizontal rotation between the tibia and calcaneus was 8 degrees in the uninjured condition; 6 degrees in the subtalar joint and 2 degrees in the ankle joint. In both medial and lateral injuries, more rotation in the subtalar joint was noted in plantar flexion phase. In the ankle joint, the degree of excessive rotation in plantar flexion range was greater in lateral injury than medial injury, but that in dorsiflexion range was greater in medial injury. It appeared that while every component of collateral ligaments around the ankle was important in controlling rotation in plantar flexion range, the posterior portion of the deltoid ligament is most important in the forsiflexion range.
使用10条正常新鲜尸体下肢，在踝关节于矢状面从最大跖屈移动至最大背屈的过程中，研究踝关节周围韧带损伤的运动学影响。在正常状态以及随后制造的损伤状态下，均拍摄了一系列前后位和侧位连续X线片，以评估后足复合体的瞬时旋转中心和水平旋转模式。尽管踝关节瞬时旋转中心的模式在正常状态下各不相同，但大多数都落在规定区域内。瞬时中心与未受伤状态下的偏差在外侧韧带损伤时最为明显。在未受伤状态下，胫骨与跟骨之间的平均水平旋转为8度；距下关节为6度，踝关节为2度。在内侧和外侧损伤中，在跖屈阶段距下关节的旋转均更为明显。在踝关节，外侧损伤时跖屈范围内的过度旋转程度大于内侧损伤，但背屈范围内内侧损伤的过度旋转程度更大。似乎虽然踝关节周围侧副韧带的每个组成部分在控制跖屈范围内的旋转时都很重要，但三角韧带的后部在背屈范围内最为重要。
