Hintermann B
Orthopädische Universitätsklinik Basel.
Swiss Surg. 1998;4(2):63-9.
The complex mechanics of the ankle joint complex depends highly on the integrity of the ankle ligaments. An incomplete restoration of the antero-fibular ligament after trauma may result in a mechanical dissociation of the talus from the ankle mortise. The force that is needed to induce a non-physiological movement of the foot is determined by the individual configuration of the bony and articular structures of the hindfoot. A pes cavus is less protected to suffer of an ankle sprain than a flatfoot. As the leverarm of the peroneal muscles decreases with increasing plantarflexion of the foot, the active protection to resist against a supination stress decreases with plantarflexion. These findings have significant implications for the practice. First of all an adequate treatment of any ankle sprain is necessary to restore the mechanical interplay of the ankle joint complex. Ankle orthoses should protect the foot against supination stress and excessive plantarflexion. The prevention of ankle injury may be significantly improved by recognition of the individual mechanical disposition.
踝关节复合体的复杂力学高度依赖于踝关节韧带的完整性。创伤后腓前韧带的不完全修复可能导致距骨与踝关节窝的机械性分离。引起足部非生理性运动所需的力取决于后足骨骼和关节结构的个体形态。高弓足比扁平足更容易发生踝关节扭伤。随着足部跖屈增加，腓骨肌的力臂减小，抵抗旋后应力的主动保护作用随跖屈而降低。这些发现对临床实践具有重要意义。首先，对任何踝关节扭伤进行充分治疗对于恢复踝关节复合体的力学相互作用是必要的。踝关节矫形器应保护足部免受旋后应力和过度跖屈的影响。通过识别个体的力学特征，踝关节损伤的预防可能会得到显著改善。
