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At least 271 records · Page 15Linked to original sources
PubMed1983

Deltoid ligament. Functional analysis of the medial collateral ligamentous apparatus of the ankle joint.

On 34 osteoligamentous ankle preparations the function of the various components of the deltoid ligament has been elucidated by tracing mobility patterns after successive transection of the components in varying sequence. The anterior and posterior talofibular ligaments were included in the study to investigate the interaction between these structures and the deltoid ligament. The tibiocalcaneal and the intermediate tibiotalar ligaments control abduction of the talus. The anterior tibiotalar and talofibular ligaments control plantar flexion, while dorsiflexion is inhibited by the posterior tibiotalar and talofibular ligaments, and partly by the anterior talofibular ligament as well. In combination, the anterior and intermediate tibiotalar ligaments control external rotation, while the intermediate and posterior tibiotalar ligaments control both external and, together with the anterior talofibular ligament, internal rotation of the talus. Isolated, neither the anterior nor the posterior tibiotalar ligament appears to play any major role in ankle stability.

Ankle Joint↗
PubMed1987

A computer-controlled system to perturb the ankle joint of freely standing cats trained to maintain a given force.

A computer-based system was developed to (1) train freely standing cats to match various target forces with the left hindlimb, (2) perturb the left ankle joint when the cat was maintaining a desired force and (3) compare reflex responses before and after decerebration. Cats quickly learned to stand unaided on 4 pedestals. During a training session, a range of target force windows was presented to the cat. A successful trial consisted of maintaining the force applied on the left rear pedestal within the target window for a preset time period. To assist the cat, a light was turned on whenever the force was within the target window. A food pellet reward was delivered by the computer after each successful trial. To test reflex responses, the position of the left hindlimb could be briefly perturbed by activating a servo-controlled printed motor configured to rotate the pedestal about the axis of the ankle joint. Perturbations that either flexed or extended the ankle joint were presented pseudo-randomly by the computer. This approach has been used to quantify the magnitude of muscle afferent volleys and the reflex EMG in ankle extensor muscles of normal and decerebrated cats, in response to similar mechanical perturbations. It has also been used to study dynamic features in the electroneurogram recorded from a cutaneous nerve by implanted nerve cuff electrodes, and the correlations among the electroneurogram, the vertical contact force applied on the pedestal and the force recorded from muscle tendons by implanted transducers. This approach may have general applications in the study of postural control, including the study of the discharge patterns of individual motor, sensory or spinal cord neurons in freely standing cats.

Animals↗
PubMed1984

Ball-and-socket ankle joint: anatomical and kinematic analysis of the hindfoot.

Ten feet in eight children with ball-and-socket ankle joint (BSA-J) are reported with discussion of associated anomalies, kinematic analysis of the hindfoot motion, and talocalcaneal malalignment in the apparent valgus deformities. BSA-J is considered to be a common congenital condition associated with other anomalies in the foot or lower extremities. Even though BSA-J seems to have unusual side-to-side motion at the ankle joint, it does not occur in patients without subtalar fusion. Moreover, apparently valgus feet are responsible for talocalcaneal malalignment, not for lateral unstable motion at the ankle.

Ankle Joint↗
PubMed1999

[MRI arthrography of the ankle joint].

Due to its superior soft tissue contrast conventional MRI is the imaging method of choice in the evaluation of ankle joint disorders. Conventional MR imaging can accurately demonstrate normal or acutely injured ligaments; however, in subacute and chronic injury joint fluid necessary for delineation of injured ligaments is absent and MR arthrography should be performed. MR arthrography uses the intraarticular injection of contrast material to distend the joint, yielding improved discrimination of intraarticular structures. This joint distension with MR arthrography is also helpful in the staging of osteochondritis dissecans, since in cases of unstable lesions tracking of contrast material into the interface can be more easily demonstrated. Finally, high contrast and joint distension by MR arthrography improves the detection of intraarticular loose bodies, which often require surgery. MR arthrography, although invasive, may provide additional information in various ankle joint disorders.

Ankle Injuries↗
PubMed1988

The mechanical characteristics of the collateral ligaments of the human ankle joint.

In the present study, the tensile mechanical properties of all of the collateral ligaments of the human ankle joint were determined, in vitro, from tensile tests conducted on 120 ligaments obtained from 20 fresh lower limbs. The ultimate load of the lateral collateral ligaments increased in an anteroposterior sequence, with the anterior fibulotalar ligament less than the fibulocalcaneal ligament and less than the posterior fibulotalar ligament. For the medial collateral ligaments, the increasing order of ultimate load was found to be tibiocalcaneal ligament, tibionavicular ligament, tibiospring ligament, posterior tibiotalar ligament. The posterior tibiotalar ligament and tibiospring ligament, so frequently neglected in the anatomical and orthopaedic literature, demonstrated the highest yield force and ultimate load of all of the collateral ligaments of the ankle. Additionally, the tibiospring ligament showed high yield and ultimate elongation properties probably related to its distal attachment to the spring ligament. The fibulocalcaneal ligament was found to have high linear elastic modulus suggesting some type of unique material properties or internal fiber organization. Knowledge of the mechanical characteristics of the ligaments of the ankle joint contributes to an understanding of their normal function, pathomechanics of injury, and their optimal surgical reparative procedure and reconstructive material. A knowledge of the normal mechanical properties of the ankle ligaments provides a data base to evaluate which of the multiplicity of present tendon graft materials has mechanical properties similar to those of the ligaments to be replaced. Those tendon grafts will be the most suitable for replacement of specific ligaments. Finally, data on the mechanical properties of these ligaments offer the possibility for evaluating any future biological or prosthetic grafts.

Aged↗
PubMed1978

Fractures and dislocations of the ankle joint.

The classification of fractures of the ankle joint is based on the mechanism of injury, which provides the clue to successful reduction. The physiological movements of the ankle and foot are defined, and the pathological movements associated with injury are described.

Ankle Injuries↗
PubMed1996

Fibula and its ligaments in load transmission and ankle joint stability.

A study was made of the role of the fibula in weightbearing and its contribution to ankle joint stability in 10 anatomic specimen lower limbs. On axial loading of the lower limb, the fibula was found to take an average of 17% of a 1500 N axial load. The proportion of the load carried by the fibula increased with the total loading. It also increased when the line of load was displaced laterally and when the ankle joint was in dorsiflexion and decreased when the line of loading shifted medially or the joint was plantar flexed. With loading, the lateral malleolus migrated distally relative to the medial malleolus, except after fibular osteotomy, when it migrated proximally. There was an approximately inverse relationship between proportional fibular loading and distal fibular migration. Cutting the inferior tibiofibular ligament reduced the proportional load in the fibula and increased its distal migration. The interosseous membrane modified the load distribution between the tibia and the fibula, with the distal fibula carrying a higher proportion of the axial load than did the proximal. Surgical repair of a ruptured inferior tibiofibular ligament, using either 1 or 2 screws, was associated with an abnormal pattern of load distribution and fibular displacement.

Ankle Joint↗
PubMed1994

A comprehensive study of pressure distribution in the ankle joint with inversion and eversion.

The understanding of load transfer characteristics is the baseline for biomechanics of the ankle joint. Changes in contact patterns of the articular cartilage from the norm may indicate pathologic conditions. Measurement of the contact in human cadaver ankles provides a direct measurement for this understanding. The force transfer characteristics of the three facets of the ankle joint were investigated. Five fresh-frozen cadaver lower extremities were tested in 12 positions under three axial loads of 490, 686, and 980 N. Fuji film served as the pressure transducer and the prints were analyzed by a computerized video digitizer. The results demonstrated that as the foot was moved into inversion or eversion with the ankle in neutral flexion or dorsiflexion, there was a decrease in total contact area and an increase in the average high pressure. In plantarflexion, the contact area was lower and the average high pressure was higher, indicating a greater force per unit area as compared with dorsiflexion and neutral flexion. In plantarflexion, however, little change was noted with inversion or eversion. In dorsiflexion, the total contact area was higher and the average high pressure slightly lower as compared with neutral flexion. With inversion, the contact area of the medial facet of the ankle increased and with eversion it increased on the lateral facet, especially in dorsiflexion. With an increase in loading, the pressure did not significantly increase but the contact area did increase. The centroid of the contact moved anteriorly to posteriorly on the talus as the joint moved from dorsiflexion to plantar-flexion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Neuropathic ankle joint in Charcot-Marie-Tooth disease after triple arthrodesis of the foot.

Charcot-Marie-Tooth disease results in pes cavus or equinocavovarus deformity. An accepted surgical correction is triple arthrodesis of the foot. In a retrospective study of 45 Charcot-Marie-Tooth patients, two cases developed neuropathic ankle joint after triple arthrodesis. This procedure prevents mobility of the tarsal joint and consequently increases stress on the ankle joint. If coupled with decreased joint sensation, it may predispose the ankle to neuroarthropathy. This paper emphasizes joint position sense as an important consideration before triple arthrodesis or any other surgical procedure.

Adolescent↗
PubMed1975

[Positive contrast arthrography in the diagnosis of ligament lesions in the upper ankle joint].

There are a great number of open questions in the diagnosis and the management of ligament lesions of the ankle joint. On the basis of the data of the literature and the author's experiences the advantages of the contrast arthrography of the ankle-joint may be resumed in the following: 1. No narcosis is necessary. 2. More exact determination of the site of the lesion is possible. 3. Therefore proper treatment may be chosen. 4. The incidental technical errors are more easily to be verified. (Paraarticular administration of the contrast medium is immediately demonstrable, whereas faulty observance of the prescriprions becomes not always evident from the roentgenogram). 5. No comparative roentgenograms are necessary. 6. The X-ray staff is not exposed to X-ray radiation.

Ankle Injuries↗
PubMed1996

Contribution of the deltoid ligament to ankle joint contact characteristics: a cadaver study.

Changes in ankle biomechanics lead to altered load transmission through the ankle joint, possibly predisposing it to osteoarthritis. Contributions of the different bands of the deltoid ligament to the contact characteristics in the ankle were examined. Fifteen normal cadaveric lower extremities were axially loaded to 445 N after intra-articular Fuji film placement. Ankles were tested in neutral, 10 degrees dorsiflexion, and 10 degrees plantarflexion. Repeated testing was done following sequential sectioning of the deltoid ligament, and the contact characteristics were analyzed. The greatest significant tibiotalar changes (P < 0.0001) occurred after sectioning of the tibiocalcaneal fibers of the superficial deltoid ligament complex. Contact areas decreased up to 43%, peak pressures increased up to 30%, and centroids moved 4 mm laterally, on average. In contrast, sectioning of the other bands led to insignificant changes in joint contact characteristics. The data indicate that significant changes in contact characteristics occur before radiographic evidence of deltoid ligament damage is evident, and may indicate that greater attention to the medial side of the ankle is indicated to restore normal biomechanics to this joint.

Analysis of Variance↗
PubMed1978

[Roentgen diagnosis of injuries of the ankle joint (author's transl)].

Lesions of the ankle joint affect the bone and/or ligaments. It will often be necessary to conduct additional radiological examinations besides the standard x-ray films. These additional examinations should include: 1. roentgenograms taken at an oblique angle; 2. x-ray films taken in forced extreme joint position in two planes; 3. roentgenograms comparing right and left; 4. arthrography. The article discusses the value and significance of the additional roentgenograms, with particular reference to the importance of the films of the forced extreme joint position.

Ankle Injuries↗
PubMedDate not supplied

Kinematic and kinetic evaluation of the ankle joint before and after tendo achilles lengthening in patients with spastic diplegia.

Fourteen patients, at a mean age of 9.1 years (range 4.1-16.6 years), who had spastic diplegic cerebral palsy were evaluated before and after tendo Achilles lengthening (TAL). Follow-up (by gait analysis) after TAL ranged from 8 to 30 months. A Vicon motion analysis system with six CCD cameras and two AMTI force plates provided three-dimensional measurements of joint motion and moments. The TAL procedure resulted in normal passive dorsiflexion of the ankle joint with the knee at 0 degrees of extension and 90 degrees of flexion, reduced plantarflexion during swing phase, and reduced premature plantarflexor moment. However, 10 degrees greater than normal dorsiflexion of the ankle joint during mid-stance phase was indicative of a mild calcaneal gait pattern. The TAL procedure improved lower extremity function as documented by both kinematic and kinetic analysis in cerebral palsy.

Achilles Tendon↗
PubMed1985

Trabecular bone strength profiles at the ankle joint.

The mechanical strength of trabecular bone at the ankle joint was studied in ten amputation specimens by means of multiple penetration tests. Tibial bone was considerably weaker than talar bone (40% on average). An area of peak bone strength located posteriorly and medially to the center of the joint was found in most joints. The variation of bone strength with the depth from the surface was studied by comparing five successive 2-mm levels. At the tibia there was a statistically significant decrease of bone strength from the first to the second level. At the talus, bone strength increased at first, then decreased significantly. The absolute values of strength recorded suggest that in a substantial number of the joints studied, the resection surfaces--especially at the tibial side--might be too weak to support the loads imposed by current prosthetic designs.

Ankle Joint↗
PubMedDate not supplied

[ligament kinematics of the ankle joint. An experimental study].

In an experimental study using osteo-ligamentous preparations of ankle joints we studied the ligamentous kinematics of isolated ligament fibers of different lateral and medial ankle ligaments. Results demonstrate a different kinematic pattern of the ligaments depending on the joint position. The anterior fibula-talar ligament shows an anisometric characteristic of different fibers and demonstrates a maximal ligament strain of the most anterior fiber in maximal plantarflexion; fibers located more dorsally have their maximal strain in plantarflexion of less degrees. In contrast to that the fibula-calcaneus ligament demonstrates a more isometric characteristic. At the medial side the different parts of the deltoid ligament also demonstrate a different kinematic characteristic. In contrast to the pars tibio-calcanearis which has a more isometric ligament kinematic of isolated fibers, ligament fibers of the pars tibiotalaris posterior demonstrate an anisometric ligament kinematic. For clinical aspects an anatomically correct reconstruction of ruptured ligaments and fractures as well as an anatomic reconstruction in chronic unstable ankle joints is recommended.

Ankle Joint↗
PubMed1996

The stabilizing effect of orthotic devices on plantar flexion/dorsal extension and horizontal rotation of the ankle joint. An experimental cadaveric investigation.

The mechanical stabilizing effect of nine different orthotic devices on physiological and pathological plantar flexion/dorsal extension and horizontal rotation of the ankle joint subjected to artificial lateral ligament lesions was investigated in 20 cadaveric ankle joints under standardized conditions using an experimental apparatus. All of the braces tested significantly reduced plantar flexion/dorsal extension, as well as internal/external/external horizontal rotation, under the experimental conditions. In so far as these results can be transposed into a clinical setting, our data favour that bracing significantly reduces the instability. But, other criteria, such as the stabilizing effect on talar tilt and anterior drawer sign, the price and the convenience of wearing such devices have to be taken into consideration when choosing the optimal brace.

Analysis of Variance↗
PubMed2002

[Prosthetic replacement of the upper ankle joint].

Results after total ankle arthroplasty in the 1970s and 1980s were poor. The outcomes of these surgeries deteriorated rather dramatically with time. Causes of failure were multifactorial, but the two main reasons for failure were constrained designs and cement fixation. Today, the design of total ankle arthroplasty is unconstrained and the fixation is uncemented. Total ankle arthroplasties are considered technically demanding procedures, with relatively high early postoperative complication rates. As yet, the ideal total ankle patient remains to be defined. Good alignment and ligamentous stability are essential. Osteonecrosis and profound osteoporosis are associated with poor results due to problems with bony fixation. Patients should be advised that the implant may fail and that this may require further surgery, including the potential need for an ankle fusion. The results of ankle fusions, although usually initially good, seem to deteriorate with time. Not uncommonly, patients frequently develop peritarsal degenerative joint disease several years after an ankle arthrodesis. Because of the associated pain and functional limitations that can follow ankle fusion, efforts to develop a workable total ankle replacement continue. At present, the long-term results of new designs are unknown. Today, total ankle arthroplasty should be limited to centers where patient volume and infrastructure allows critical review and prospective clinical trials to determine the factors leading to successful and unsuccessful outcomes.

Ankle Joint↗