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At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Ultrasonography of capsular morphology in normal and traumatic ankle joints.

Ultrasonography was used to inspect the ankle anatomy of 20 healthy volunteers. The images produced were correlated with anatomical structures by examining three dissected cadaver ankles. The anterolateral pouch of the articular capsule was identified by ultrasonography in 91% of the normal ankle joints as a hypoechoic area. The posterolateral pouch of the articular capsule also could be identified by ultrasonography as a hypoechoic area in 84% of the normal ankles examined. The lateral aspect of 105 traumatized ankles was examined subsequently. The ultrasound results agreed in 100% of the cases with the operative findings for the anterior talofibular ligament and in 92% for the calcaneofibular ligament.

Adult↗
PubMed1997

[Determination of cartilage thickness in the ankle joint. an MRT (1.5)-anatomical comparative study].

PURPOSE: The aim of this study was to evaluate the accuracy of MRI in the measurement of cartilage thickness of the ankle joint in comparison to pathologic and histologic specimens. PATIENTS AND METHODS: The ankle joints of four fresh cadaver feet were imaged on a 1.5T MR-unit in the coronal plane. Standard T1-weighted spin echo (SE) and a T1-weighted 3D-GE (FLASH-3D) sequence with fat saturation were applied. Following MR imaging, the talus was explanted and cut parallel to the MR images for macroscopic evaluation and histologic specimens were prepared. MRI measurements of the cartilage thickness of the talus were carried out in two ways: without and with consideration of a transition zone of intermediate signal intensity between hyperintense cartilage and hypointense cortical bone. The data were compared with the anatomic specimens as the gold standard expressing the difference as a percentage value. On histologic specimens thickness of deep calcified cartilage layer was measured. RESULTS: Measurements without the transition zone showed a mean underestimation of talus cartilage thickness of 46.8% (41.3-52.1) for T1-SE and 47.5% (43.1-52.1) for fat saturated FLASH-3D images. Considering the transition zone the mean values were 25.0% (23.1-26.2) and 14.1% (6.7-21.5). The histologic specimens showed a three-fold increase of thickness of deep calcified cartilage layer. CONCLUSIONS: Measurements of the cartilage layer of the ankle joint on MR images are only accurate if the transition zone (calcified cartilage layer) is considered and the optimal pulse sequence (FLASH-3D-fat-sat) is applied.

Aged↗
PubMed2002

Stiffness and passive peak force changes at the ankle joint: the effect of different joint angular velocities.

OBJECTIVE: To compare peak force and stiffness at the ankle joint in response to repetitive dorsiflexion at two joint angular velocities (5 and 25 deg s(-1)). DESIGN: Pre- post-repeated measures design. BACKGROUND: Stretching affects the biomechanical properties of tissues. In many instances, stretching is performed in a cyclic manner. An important factor that might influence the effects of stretching is the speed at which the tissues are lengthened. METHODS: Eighteen healthy subjects participated. A dynamometer repeatedly moved the ankle joint from 0 deg of dorsiflexion to 80% of maximum dorsiflexion over a 2 min period. Two joint angular velocities were examined: 5 and 25 deg s(-1). Force and angle data were recorded simultaneously. Electromyographic activity from plantar and dorsiflexor muscles was monitored. The variables of interest were peak passive force and average stiffness at the first and last repetition of motion. RESULTS: Peak force was significantly higher (P < 0.05) at 25 deg s(-1) for the first repetition. At both joint angular velocities, peak passive force decreased significantly over the 2 min of motion. The decreases were 13% and 21% at 5 and 25 deg s(-1) respectively. Peak passive force was not significantly different (P > 0.05) across velocities at 2 min. Stiffness was greater at 25 deg s(-1) initially (P < 0.05), however, it decreased significantly across time. The magnitude of the decrease was 20% and 31% at 5 and 25 deg s(-1) respectively. After 2 min of motion, there was no significant difference (P > 0.05) in stiffness across the joint angular velocities examined. CONCLUSION(S): The findings showed that while significant differences existed in stiffness and peak force across angular velocities at the start of the stretching motion, the differences decreased considerably with repeated motion, and were relatively similar within 2 min. RELEVANCE: It has long been thought that greater speeds of stretch are more likely to lead to muscle injury. Our findings suggest that it is most beneficial to stretch at a slow speed initially, thereafter, the speed of stretch may be increased.

Adult↗
PubMed1987

[Involvement of the inner malleolus and deltoid ligament in supination trauma of the ankle joint].

Additional ligament ruptures or fractures of the medial side of the ankle joint accompanying the lateral ligament rupture are rare. These injuries are more often in traumas with pronation-eversion movements of the foot. In cases of lateral ligaments ruptures we only found in 2.8% and in 5.9% additional medial injuries. This is confirmed by different biomechanical experiments. Experimentally the delta ligament rupture could mostly be caused by pronation-eversion movements or by forced plantar flexion of the foot. The diagnosis of bony lesions of the medial malleolus might be easy by X-ray, but ligament lesions of the medial ankle joint can be diagnosed easily too be using the stress X-ray controlling the medial talar tilt as a sign of medial instability. Because the necessity of surgical treatment is less important than of the lateral ligaments we recommend this procedure in cases of bilateral instability or if dislocation is obvious.

Ankle Injuries↗
PubMed2004

Ankle joint proprioception and passive mechanical properties of the calf muscles after an Achilles tendon rupture: a comparison with matched controls.

OBJECTIVE: To examine if ankle joint proprioception, passive stiffness, and torque relaxation responses of the involved and uninvolved limbs of persons with a previous history of an Achilles tendon rupture were different from matched controls. DESIGN: Quasi-experimental mixed design. BACKGROUND: The influence of an Achilles tendon rupture on the proprioceptive and kinetic performance of the involved and uninvolved ankle is not known. METHODS: Twenty persons (mean age, 44.8 years) with a unilateral rupture and 20 matched controls (mean age, 44.2 years) volunteered. Proprioception was tested with a position-matching protocol from which absolute errors were quantified. A dynamometer was used to measure ankle joint angle and passive torque from which stiffness and torque relaxation were calculated. RESULTS AND CONCLUSIONS: Proprioception absolute errors for the involved and uninvolved limbs of the experimental group were 27% and 31% greater respectively, than values for the control group. Torque relaxation values were greater in the involved limb versus the uninvolved limb or the control group (P=0.003-0.04). In conclusion, participants with a previous history of an Achilles tendon rupture display proprioception deficits in both limbs and greater torque relaxation in the involved limb in comparison to matched controls. RELEVANCE: Bilateral deficits in ankle joint proprioception, as reported in this study, suggest the uninvolved limb may not serve as an effective control and because proprioception deficits influence some functional tests, Achilles tendon rupture patients may benefit from proprioception training.

Achilles Tendon↗
PubMed1992

Total ankle joint replacement: a clinical follow up.

The TPR total ankle joint replacement system (Smith & Nephew Richards) was implanted in 30 ankles in 25 patients. Twenty-three ankles in 18 patients were followed; 21 had rheumatoid arthritis and two had osteoarthritis. The average age at surgery was 62 years (range: 37 to 77), and the average follow up was 59 months (range: 37 to 89). The improvement was especially obvious with respect to pain and function. The average walking distance improved from 260 m preoperatively to 975 m postoperatively. Even though there was some improvement with respect to pain and function, the results of the study are disappointing in comparison to studies of ankle arthrodesis.

Adult↗
PubMed1988

A study of 5-HT-receptors associated with afferent nerves located in normal and inflamed rat ankle joints.

Neural recordings were made from sensory fibres in a nerve supplying the ankle joint in normal rats and in rats with a novel monoarticular arthritis. The responses of mechanically and chemically sensitive units to intra-arterial injections of 5-HT were measured. In most cases the mechanosensitivity of sensory receptors in the ankle joint was not altered by 5-HT. However, 5-HT produced an increase in afferent activity in units which were identified as C-fibres on the basis of action potential amplitude and duration. The receptive fields of these chemosensitive units were not located. The responses of these units to 5-HT were dose dependent and were abolished by the 5-HT2-antogonist, ketanserin, but not by the 5-HT3-receptor antagonist, MDL 72222. The responses of chemosensitive units to injections of 5-HT were similar in normal and arthritic rats although the response was slightly prolonged in arthritic animals.

Action Potentials↗
PubMed1980

[Morphology and clinical aspect of the lateral ligaments of the ankle joint (author's transl)].

The direction of movement and the range of movement of a joint are determined by the lengths of the ligaments and the positions of their origins and insertions. It follows that any operation which alters the length of a ligament or moves one of its points of attachment is unphysiological. Reconstruction should be carried out with due regard to the normal anatomy. In the ankle joint, for example, the tip of the lateral malleolus should be left free of ligamentary insertions. Until now, anatomical illustrations have shown the lateral ligaments of the ankle joint to be attached to the anterior border of the fibula and to its anterior and lateral surface. All the older illustrations emphasize a band of fibers which passes directly from the neck of the talus to the calcaeus. This band varies in thickness and always forms the base of the triangle formed by the anterior talofibular ligament and the calcaneofibular ligament. Examination of surgical specimens and amputated ankle joints shows that the lateral tip of the fibula is free of ligamentary insertions. The lateral fibular ligaments are attached to the distal end of the fibula around the border of the cartilaginous foint surface. The only fibers which are derived from the lateral surface are those from the periosteum. This fact is of considerable importance in reconstructive surgery of the ankle joint, since strong ligamentary insertions which surround the lateral surface of the fibula necessarily oppose rotation or screw-like movement of the fibula about its longitudinal axis.

Adult↗
PubMedDate not supplied

The effect of simulated tibial deformities on the ankle joint during the gait cycle.

The effect of angular deformities of the tibial shaft on the area, location, and shape of the ankle joint contact during the normal extremes in the gait cycle was studied with the use of a cadaveric model. Six lower limbs were first examined radiographically and found to be free of pathology. These specimens were then stripped of soft tissues proximal to the ankle joint and had a custom-designed universal joint-plate inserted into the tibia at the proximal, middle, or distal third level. An anterior ankle arthrotomy was performed, and pressure sensitive film was inserted into the tibiotalar joint. Load was then applied with the ankle set in dorsiflexion or plantarflexion via metal wedges, and tibial deformities of 5, 10, and 15 degrees were simulated in varus, valgus, anterior bow, and posterior bow. Contact area and location changes were noted to be of greater magnitude with proximal and distal third tibial deformities than with middle third deformities. Varus and valgus deformities showed smaller contact area changes than anterior or posterior bow deformities. Contact area changes tended to be larger in dorsiflexion compared to plantarflexion for each level and degree of tibial angulation. Posterior bow deformities at all levels resulted in greater changes in contact area and shape than other deformities. The role of subtalar compensation, stiffness of the foot-ankle complex, and geometric factors are all thought to influence the changes noted. On the basis of this experimental study it would appear that angular deformity of the tibia less than 10 degrees would not significantly alter ankle joint contact.

Ankle Joint↗
PubMed1998

Anatomy of the collateral ligaments of the human ankle joint.

Damage to the collateral ligaments of the ankle is relatively common, particularly the lateral ligaments; therefore, it is important to be aware of the detailed anatomy and frequency of variation of the individual ligaments. Only two reports of collateral ligaments dimensions were found in the literature, neither of which considers all of the individual components of the collateral ligament complex. Osteoligamentous preparations of the collateral ligaments of 40 ankles from 20 cadavers of European Caucasian origin were studied, from which mean values for the length and width of the individual components were determined, together with their frequency of occurrence. For the collateral ligaments of the ankle as a whole, the ligamentous dimensions determined in this study are similar to those reported previously. The data presented in this study are, therefore, a valuable addition to the small pool of data that exists concerning the dimensions of the collateral ligaments of the human ankle joint. These data may be of value when considering surgical repair or reconstruction of traumatized collateral ligaments, especially because any undue foreshortening of the ligaments may reduce the range of motion possible at either the ankle or subtalar joints, or both. It is possible that in extreme cases, such a reduction in the range of motion may modify gait patterns and the transmission of stresses across the joints of the foot and lower limb.

Aged↗
PubMedDate not supplied

Posterior block of the ankle joint in dancers.

The presence of a bony block at the back of the ankle should be recognized as occurring in patterns of symptoms which are not themselves directly related to the ankle joint. When careful examination and observation of the patient indicates that the source of the trouble is in fact at the back of the ankle joint and it has been determined that there is some extra bone at this site, then surgical treatment will give excellent results. It must be emphasized that the presence of an os trigonum or other bony prominence does not mean that it is the source of recurrent symptoms. Surgery should certainly be delayed until all conservative measures have failed to relieve the symptoms or prevented them from recurring constantly. Frequently, strengthening of the forefoot and other relevant areas in the lower limb is sufficient to alleviate symptoms and allow the patient to continue to dance fully.

Achilles Tendon↗
PubMed2002

The effect of prolonged static and cyclic stretching on ankle joint stiffness, torque relaxation, and gait in people with stroke.

BACKGROUND AND PURPOSE: Continuous passive motion (cyclic stretching applied to the subject's limb) has been used for the rehabilitation of some orthopedic impairments; however, few researchers have considered its application in the management of neurological disorders such as stroke. The purpose of this study was to examine the short-term effects of prolonged static and cyclic calf stretching on passive ankle joint stiffness, torque relaxation, and gait in people with ischemic stroke. SUBJECTS: Ten community-dwelling people (mean age=64.6 years, SD=8.76, range=53-76) who were diagnosed with a cerebrovascular accident volunteered to be subjects. METHODS: Participants engaged in one 30-minute static stretch and one 30-minute cyclic stretch of the calf muscle, using an isokinetic dynamometer that also collected torque and angle measurements. Before and after treatments, 10-m walking times were collected. Ankle joint stiffness was calculated from the slope of the torque and angle curves before and immediately after treatments, and torque relaxation was calculated as the percentage of decrease in peak passive torque over the 30-minute stretch durations. RESULTS: Ankle joint stiffness decreased by 35% and 30% after the static and cyclic stretches, respectively. Stiffness values and 10-m walk times were not different between conditions. The amount of torque relaxation was 53% greater for static stretching than for cyclic stretching. DISCUSSION AND CONCLUSION: These preliminary data from a very small sample of people with stroke indicate that ankle joint stiffness decreases after both prolonged static and cyclic stretches; however, neither technique appears to be better at reducing stiffness in people with stroke. Torque relaxation is greater after static stretching than after cyclic stretching, and walking speed does not appear to be influenced by the stretching treatments used in our study.

Aged↗
PubMed1979

[Results of arthrodesis of the ankle joint (author's transl)].

We present a check-up study of 47 arthrodeses of the ankle joint, partly in combination with an arthrodesis of the subtalar joint. By resection-compression-arthrodesis following Charnley-Horwitz-Adams we reached a bony fusion of the ankle joint in all cases. 83% of our cases showed a good or at least fair result. The remaining patients complained of painful walking in spite of orthopaedic shoes. In these cases a further fusion of subtalar joints especially of the talo-navicular joint should be considered.

Accidents, Occupational↗
PubMed1980

[The tenodesis of the peroneus muscle for the treatment of the chronic insufficiency of the lateral ligaments of the upper ankle joint (author's transl)].

Thirty-eight cases presenting with chronic instability of the ankle joint have been examined. Tenodesis using peroneus brevis has given satisfactory results in 29 cases and poor results in 9 cases (after the method of assessment by Weber). We have classified instability of the ankle joint in a functional way from Types I to III. In Type III, an extended form of tenodesis is required.

Adult↗
PubMed1975

Engineering considerations in the design of an ankle joint.

A prothesis has been designed to replace the articulating surfaces of the human ankle joint. The prothesis is in two parts, each forming a segment of a right circular cylinder with a single axis of rotation. The concave tibial component is manufactured from ultra-high molecular weight polyethylene and the talar component is manufactured from medical grade stainless steel. It is likely, however, that the talar component will be commercially manufactured from cobalt chrome alloy (Vitallium or Vinertia). The two components are secured to the cancellous bone by polymethylmethacrylate bone cement and laboratory tests have indicated that the bond should be strong enough to withstand the loads encountered at the ankle joint in vivo. The tests have also shown that the stability and strength of the ankle are not seriously reduced by implantation of the prosthesis. Laboratory wear tests and clinical experience over the last two years encourage optimism over the long term performance of the prothesis.

Adult↗
PubMed2005

Consequences of ankle joint fixation on FES cycling power output: a simulation study.

INTRODUCTION: During fixed-ankle FES cycling in paraplegics, in which the leg position is completely determined by the crank angle, mechanical power output is low. This low power output limits the cardiovascular load that could be realized during FES ergometer cycling, and limits possibilities for FES cycling as a means of locomotion. Stimulation of ankle musculature in a released-ankle setup might increase power output. However, releasing the ankle joint introduces a degree of freedom in the leg that has to be controlled, which imposes constraints on the stimulation pattern. METHODS: In this study, a forward dynamics modeling/simulation approach was used to assess the potential effect of releasing the ankle on the maximal mechanical power output. RESULTS: For the released-ankle setup, the optimal stimulation pattern was found to be less tightly related to muscle shortening/lengthening than for the fixed-ankle setup, which indicates the importance of the constraints introduced by releasing the ankle. As a result, the maximal power output for 45-RPM cycling in the released-ankle setup was found to be about 10% lower than with a fixed ankle, despite the additional muscle mass available for stimulation. Power output for the released-ankle setup can be improved by tuning the point of contact between the foot and pedal to the relative strength of the ankle plantar flexors. For the model used, power output was 14% higher than for the fixed-ankle setup when this point of contact was moved posteriorly by 0.075 m. CONCLUSION: Releasing the ankle joint and stimulating the triceps surae and tibialis anterior is expected to result in a modest increase in power output at best.

Acceleration↗
PubMed1975

[Internal compression arthrodesis of the ankle joint (with examination of stability for comparison].

A new technique of arthrodesis of the ankle joint by internal fixation with self-compression blade-plates is presented. The both possible techniques of inserting the plate lateraly or medialy are described. We prefer the lateral approach. After resection of the ankle joint we also resect the tibiofibular syndesmosis putting than in a transfixion screw. We than compare under biomechanical aspects the new techniques with Charnley's external fixation with compression clamps. The osteosynthesis with blade-plates gives a higher stability in which external splintage with plaster becomes unnecessary. Following our experiences consolidation occurs after 8 tp 12 weeks.

Ankle Joint↗
PubMed1996

Ankle joint dorsiflexion measurement studies. A review of the literature.

A spectrum of techniques exists to measure ankle joint dorsiflexion range of motion. However, information pertaining to the objective assessment of ankle joint dorsiflexion is controversial. Different study designs make comparisons of studies difficult which leads to measurement error. These errors can be related to the examiner, the subject, or the procedure. This author reviews the sources of measurement inaccuracies within the clinical setting and describes effective interventions used to reduce measurement error.

Ankle Joint↗