Bahr R, Pena F, Shine J, Lew W D, Engebretsen L
University of Sport and Physical Education, Oslo, Norway.
Knee Surg Sports Traumatol Arthrosc. 1998;6(2):115-21. doi: 10.1007/s001670050083.
The aims of this study were to measure the forces in the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) and the motion in the tibiotalar and subtalar joints during simulated weight-bearing in eight cadaver ankle specimens. An MTS test machine was used to apply compressive loads to specimens held in a specially designed testing apparatus in which the ankle position (dorsiflexion-plantarflexion and supination-pronation) could be varied in a controlled manner. The forces in the ATFL and CFL were measured with buckle transducers. Tibiotalar motion and total ankle joint motion were measured with an instrumented spatial linkage. The specimens were positioned sequentially at 10 degrees dorsiflexion, neutral, and 10 degrees and 20 degrees plantarflexion, and this sequence was repeated at 15 degrees supination, neutral pronation/supination, and 15 degrees pronation. Force and motion measurements were recorded in each of these positions with and without a 375 N compressive load simulating weight-bearing. From 10 degrees dorsiflexion to 20 degrees plantarflexion, all motion occurred in the tibiotalar joint. In contrast, the ratio of subtalar motion to tibiotalar motion was 3:1 for supination-pronation and 4:1 for internal-external rotation. Inverse loading patterns were observed for the ATFL and CFL from plantarflexion to dorsiflexion. Compressive loading did not affect CFL tension, but it magnified the pattern of increasing ATFL tension with plantarflexion. The largest increase in ATFL force was observed in supination and plantarflexion with a compressive load (76 +/- 23 N), whereas CFL tension mainly increased in supination and dorsiflexion with a compressive load (109 +/- 28 N). In conclusion, the results showed that the ATFL acted as a primary restraint in inversion, where injuries typically occur (combined plantarflexion, supination and internal rotation). Also, the subtalar joint was of primary importance for normal supination-pronation and internal-external rotation.
本研究的目的是测量8个尸体踝关节标本在模拟负重过程中距腓前韧带（ATFL）和跟腓韧带（CFL）的受力情况以及胫距关节和距下关节的运动情况。使用MTS试验机对置于专门设计的测试装置中的标本施加压缩载荷，在该装置中踝关节位置（背屈-跖屈和旋后-旋前）可以以可控方式变化。使用扣式传感器测量ATFL和CFL中的力。使用仪器化的空间连杆测量胫距关节运动和全踝关节运动。标本依次置于背屈10度、中立位、跖屈10度和20度，此序列在旋后15度、中立位旋前/旋后和旋前15度时重复。在有和没有模拟负重的375 N压缩载荷的情况下，记录这些位置中的每一个位置的力和运动测量值。从背屈10度到跖屈20度，所有运动均发生在胫距关节。相比之下，距下关节运动与胫距关节运动的比例在旋后-旋前时为3:1，在内外旋转时为4:1。从跖屈到背屈观察到ATFL和CFL的反向加载模式。压缩载荷不影响CFL张力，但它放大了随着跖屈ATFL张力增加的模式。在旋后和跖屈且有压缩载荷时观察到ATFL力的最大增加（76 +/- 23 N），而CFL张力主要在旋后和背屈且有压缩载荷时增加（109 +/- 28 N）。总之，结果表明ATFL在通常发生损伤的内翻（联合跖屈、旋后和内旋）中起主要限制作用。此外，距下关节对于正常的旋后-旋前和内外旋转至关重要。
