Rosenbaum D, Becker H P, Wilke H J, Claes L E
University of Ulm, Germany.
J Bone Joint Surg Br. 1998 Jan;80(1):162-8. doi: 10.1302/0301-620x.80b1.8014.
To study the effect of ligament injuries and surgical repair we investigated the three-dimensional kinematics of the ankle joint complex and the talocrural and the subtalar joints in seven fresh-frozen lower legs before and after sectioning and reconstruction of the ligaments. A foot movement simulator produced controlled torque in one plane of movement while allowing unconstrained movement in the remainder. After testing the intact joint the measurements were repeated after simulation of ligament injuries by cutting the anterior talofibular and calcaneofibular ligaments. The tests were repeated after the Evans, Watson-Jones and Chrisman-Snook tenodeses. The range of movement (ROM) was measured using two goniometer systems which determined the relative movement between the tibia and talus (talocrural ROM) and between the talus and calcaneus (subtalar ROM). Ligament lesions led to increased inversion and internal rotation, predominantly in the talocrural joint. The reconstruction procedures reduced the movement in the ankle joint complex by reducing subtalar movement to a non-physiological level but did not correct the instability of the talocrural joint.
为研究韧带损伤及手术修复的效果，我们在七具新鲜冷冻小腿标本上，于韧带切断及重建前后，对踝关节复合体、距小腿关节和距下关节的三维运动学进行了研究。足部运动模拟器在一个运动平面上产生可控扭矩，同时允许在其余平面上自由运动。在测试完整关节后，通过切断距腓前韧带和跟腓韧带模拟韧带损伤，再次进行测量。在进行埃文斯（Evans）、沃森 - 琼斯（Watson-Jones）和克里斯曼 - 斯诺克（Chrisman-Snook）肌腱固定术后，再次重复测试。使用两个测角仪系统测量运动范围（ROM），该系统可确定胫骨与距骨之间的相对运动（距小腿关节ROM）以及距骨与跟骨之间的相对运动（距下关节ROM）。韧带损伤导致内翻和内旋增加，主要发生在距小腿关节。重建手术通过将距下关节运动减少到非生理水平，从而减少了踝关节复合体的运动，但并未纠正距小腿关节的不稳定。
