Thoma W, Scale D, Kurth A
Orthop. Univ. Klinik Frankfurt a.M.
Z Orthop Ihre Grenzgeb. 1993 Jan-Feb;131(1):14-7. doi: 10.1055/s-2008-1039897.
Usually the upper ankle joint is described as a typical hinge though it had been often remarked that the axis of rotation moves considerably with regard to the angular adjustment between the tibia and the trochlea tali. In the present study the relation between the movements in the upper ankle joint and the geometry of the lateral ligaments was analysed. The contours and elected landmarks of 6 dissected ankle joints were measured using a digitizer which allowed the computerized scanning of motion x-rays. In addition the proximal and distal insertion planes of the lateral ligaments were registered. Mathematical procedures were applied on the experimental data to predict the kinematic principles. The model of an hinged joint could not reproduce the motion curve which was actually found. Using the model of a link chain with four pivots, which was determined by the course of the talofibular and the calcaneofibular ligament, a good correlation with the experimental results was evident. This model implies a rotary and gliding component in the movement of the tibia against the trochlea tali. Beside the correspondence with the data of the present study the model allows an easy explanation of many other well known morphologic phenomena of the upper ankle joint for which a stringent interpretation was not yet available.
通常,上踝关节被描述为典型的铰链关节,不过人们常指出,随着胫骨与距骨滑车之间角度调整,旋转轴会有相当大的移动。在本研究中,分析了上踝关节运动与外侧韧带几何结构之间的关系。使用数字化仪测量了6个解剖踝关节的轮廓和选定的标志点,该数字化仪可对运动X射线进行计算机扫描。此外,还记录了外侧韧带的近端和远端附着平面。对实验数据应用数学程序来预测运动学原理。铰链关节模型无法再现实际发现的运动曲线。使用由距腓韧带和跟腓韧带走行确定的具有四个枢轴的链节模型,与实验结果有明显的良好相关性。该模型表明胫骨相对于距骨滑车的运动中存在旋转和滑动成分。除了与本研究数据相符外,该模型还能轻松解释上踝关节许多其他众所周知的形态学现象,而此前尚无严格的解释。