Bahr R, Pena F, Shine J, Lew W D, Tyrdal S, Engebretsen L
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, USA.
Am J Sports Med. 1997 Jul-Aug;25(4):424-32. doi: 10.1177/036354659702500402.
We wanted to use biomechanical testing in a cadaveric model to compare the Broström repair, the Watson-Jones reconstruction, and a new anatomic reconstruction method. Eight specimens were held in a specially designed testing apparatus in which the ankle position (dorsiflexion-plantar flexion and supination-pronation) could be varied in a controlled manner. Testing was done with intact ligaments and was repeated after sectioning of the anterior talofibular ligament and the calcaneofibular ligament and after a Broström repair, a Watson-Jones reconstruction, and a new anatomic reconstruction were performed. An anterior drawer test was performed using an anterior translating force of 10 to 50 N, and a talar tilt test was performed using a supination torque of 1.1 to 3.4 N-m. The forces in the anterior talofibular ligament and calcaneofibular ligament were measured with buckle transducers, and tibiotalar motion and total ankle joint motion were measured with an instrumented spatial linkage. The increase in ankle joint laxity observed after sectioning of both the anterior talofibular and calcaneofibular ligaments was significantly reduced by the three reconstructive techniques, although not always to the level of the intact ankle. Joint motion was restricted after the Watson-Jones procedure compared with that in the intact ankle. Unlike the Watson-Jones procedure, the ligament or graft force patterns observed during loading after the Broström repair and the new anatomic technique resembled those observed in the intact ankle.
我们希望在尸体模型中进行生物力学测试，以比较布罗斯特罗姆修复术、沃森-琼斯重建术和一种新的解剖重建方法。八个标本被放置在一个专门设计的测试装置中，在该装置中，踝关节位置（背屈-跖屈和旋前-旋后）可以以可控方式变化。在韧带完整时进行测试，并在前距腓韧带和跟腓韧带切断后，以及在进行布罗斯特罗姆修复术、沃森-琼斯重建术和一种新的解剖重建术后重复进行测试。使用10至50 N的向前平移力进行前抽屉试验，并使用1.1至3.4 N·m的旋前扭矩进行距骨倾斜试验。用扣式传感器测量前距腓韧带和跟腓韧带中的力，并用仪器化空间连杆测量胫距运动和全踝关节运动。尽管三种重建技术并不总是能使踝关节松弛度恢复到完整踝关节的水平，但在前距腓韧带和跟腓韧带切断后观察到的踝关节松弛度增加被这三种重建技术显著降低。与完整踝关节相比，沃森-琼斯手术后关节活动受限。与沃森-琼斯手术不同，布罗斯特罗姆修复术和新的解剖技术在加载过程中观察到的韧带或移植物力模式与完整踝关节中观察到的相似。
