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At least 289 records · Page 16Linked to original sources
PubMed1987

[Clinical results of sonographic functional studies of lesions of the capsule and ligaments of the knee and ankle joint].

The authors conducted a clinical study to examine whether sonographic examinations of function would be a reliable alternative to x-ray films of the forced extreme joint position in lesions of capsule and ligament of the knee and ankle joints. Sonographic standard planes of section are defined and the results of the described examination methods in 200 patients are demonstrated. Ruptures of the external ligaments of the ankle joint as well as cruciate and collateral ligament instabilities at the knee joint are simple and safe to assess and document via sonography.

Ankle Injuries↗
PubMed1996

[Concomitant injuries after upper ankle joint dislocations].

Functional treatment with the Air Stirrup Ankle Brace recommended by C. N. Stover in 1979 can reduce pathological inversion of the ankle joint. In our retrospective study of 109 patients treated by this kind of ankle brace we found 96 patients (88%) with excellent results. Only 13 patients (12%) reported moderate to good results. To detect and characterize their painful conditions of ankles we did a clinical, radiological and MRI-Investigation. In only 2 cases we found a moderate instability after clinical investigation, anterior stress roentgenogram and talar tilt. By using the MRI-investigation 1.0 Tesla with a 512 x 360 Matrix we could find 10 cases with osteochondral lesions of the ankle. In 7 cases there was separated ossicle in the fibulotalar joint, in 1 case we detected a fracture of the processus anterior tali, in another case we could see a posttraumatic lesion of the talus and calcaneus with bone bruise and at least one osteochondral fracture of the distal tibia. The capability of the MRI to detect particularly osteo-chondral lesions of the talus and the tibiofibular joint was shown in 10 of 13 cases. Therefore we recommend to do an MRI-investigation on all patients after ankle sprain if there are painful conditions within the ankle after conservative treatment.

Adult↗
PubMed1982

Ankle joint biomechanics.

A three-dimensional analysis of the human ankle joint is presented to analyse data obtained from gait laboratory tests. The ankle was treated as consisting of two joints, the talocrural (Tc.) and the talocalcaneonavicular (Tcn.), and relevant anatomical dimensions were based upon cadaveric anthropometric data. Seven adult male subjects were studied during the stance phase of normal locomotion. Data was acquired from three orthogonally placed cine cameras and a force platform. Two models were investigated based on force equilibrium; a Mark I model which excluded the posterior tibial and peroneal muscle groups and a Mark II model, which included them. The Mark II model gave the following resultant peak forces expressed as multiples of body weight; Tc. joint force = 3.9; Tcn. joint forces--anterior facet = 2.4, posterior facet = 2.8. The latter model was felt to have good potential in the analytical assessment of ankle pathologies and endoprostheses.

Adult↗
PubMedDate not supplied

Comparison of two anatomic reconstructions for chronic lateral instability of the ankle joint.

Two anatomic reconstructions for correction of chronic lateral ankle joint instability were compared. In a prospective, randomized study, 60 patients were allocated to one of two treatment groups: reconstruction of the ligaments as described by Karlsson et al. (Group I) or with the modification of the Broström procedure as described by Gould et al. (Group II). The functional results were evaluated with a scoring scale, and the mechanical stability with standardized stress radiographs. The minimum follow-up period was 2 years. The functional results were satisfactory in 27 of 30 (90%) patients in Group I and 25 of 30 (83%) in Group II. There was no significant difference between the groups regarding mechanical stability. The mean anterior talar translation in Group I was 7.1 mm (range, 4 to 10) at followup, compared with 6.7 mm (range, 3 to 9) in Group II. The corresponding values for talar tilt were 4.9 degrees (range, 0 degree to 8 degrees) in Group I and 4.4 degrees (range, 0 degree to 8 degrees) in Group II. The duration of operation time was significantly longer in Group II and surgical complications were more frequent, probably due to the more extensive surgical exposure. This study showed that the majority of patients with chronic ankle instability can be successfully treated with anatomic reconstruction of the lateral ankle ligaments. Mechanical stability was restored with both methods.

Activities of Daily Living↗
PubMed2006

[Intramedullary locked fixation and compression nail (IP-XS-Nail): treatment of ankle joint fractures].

OBJECTIVE: Reconstruction of the anatomy of the ankle joint while protecting the soft tissue, and osteosynthesis to maintain stability for function and weight bearing. INDICATIONS: Distal fractures of the fibula, bimalleolar fractures, and isolated fractures of the medial malleolus. CONTRAINDICATIONS: Very small (< 5 mm) distal fragments (if fixation of the fragments is not possible using a small XXS nail) and very narrow (< 2.5 mm) medullary cavity (conversion to plate fixation). SURGICAL TECHNIQUE: With displaced fibula fractures, open reduction should be performed with fracture retention using wide-armed reduction forceps, insertion of a central guide wire into the medullary cavity, use of a cannulated drill bit, introduction of the nail using an aiming arm and locked fixation with threaded wire. After checking the position using X-ray, the wire should be shortened using the bolt cutters. POSTOPERATIVE MANAGEMENT (Depending on the Weber classification): Full weight bearing for all isolated distal fractures of the fibula (Weber types A and B) and isolated fractures of the medial malleolus. For distal fractures of the fibula (Weber types A and B) with additional fracture of the medial malleolus or involvement of the medial ligament partial weight bearing of 20 kp for 4 weeks, followed by full weight bearing. For all Weber C fractures and/or additional Volkmann fracture only 10 kp of partial weight bearing with a rocker-sole orthosis should be allowed for 6 weeks followed by full weight bearing. No weight bearing for 6 weeks until the screws are removed is only recommended, if positioning screws have been used for Weber C fractures. RESULTS: In the period from 05/2000 to 01/2002, 194 ankle fractures were treated with the IP-XS-Nail((R)). Follow-up examinations were conducted on 162 patients with an average age of 51.2 years after an average of 15 months. 62 Weber B fractures (38.3%) and 45 Weber C fractures (27.7%) were evaluated. There were bimalleolar fractures in 55 cases (34.0%). According to the Olerud Score (clinical and radiologic score), 95 patients (58.6%) had an excellent, 54 (33.3%) a good, nine (5.5%) a moderate, and four (2.4%) an unsatisfactory result.

Adolescent↗
PubMed1995

The dynamic response of the cat ankle joint during load-moving contractions.

The dynamic response of the cat's ankle joint during load-moving activation of the medial gastrocnemius was determined. Sinusoidal-input oscillations of ankle plantar flexion were performed by the muscle at frequencies ranging from 0.4 to 5 Hz against a 10-N load acting via a cable through a pulley with a 2 cm radius. This was followed by sinusoidal muscle length changes against the same load while excluding the joint. The frequency responses of the two conditions were compared and decomposed in terms of their relative phase and gain, and best-fit pole-zero models to yield the dynamic model of the joint isolated from the muscle properties. The muscle displacement transfer function M(j omega) was characterized as two sets of double poles at 2.1 and 3.2 Hz, with a pair of zeros at 0.92 and 20 Hz, and pure time delay of 8 mS. The joint model J(j omega) was obtained by adding a pole at 5 Hz and a zero at 13 Hz. It was concluded that the ankle joint acts as a lag system, introducing significant increase in the phase lag between stimulus input and mechanical output without affecting the frequency-dependent attenuation of gain. Average harmonic distortion was less than 5% in all cases. This particular finding reveals that, despite its inherently nonlinear mechanical characteristics, the joint introduces no degradation in the simplified linear behavior of the muscle-joint system. This model is useful in the design of systems employing electrical stimulation to restore movement to limbs paralyzed by spinal cord injury or stroke.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

A method to determine the range of motion of the ankle joint complex, in vivo.

The purpose of this investigation was to develop a method to quantify a range of motion of the ankle joint complex (AJC) in vivo. A six-degree-of-freedom apparatus was constructed to measure the unconstrained active range of motion of the AJC. Extensive tests evaluating the accuracy of the fixture and data collection protocol were conducted. Euler angles similar to dorsiflexion-plantarflexion, eversion-inversion, and abduction-adduction were used to quantify the range of motion. Significantly greater (p < 0.05) values were found for plantarflexion, inversion, and abduction of a young group of male subjects (n = 7) compared to an elderly group of male subjects (n = 10). In addition, maximum range of motion values did not necessarily occur from the neutral position. In future, this method can be used to help investigate the relationships between AJC motion and injury, changes in range of motion as a function of age, and design of prosthetic ankle joints.

Adult↗
PubMed1981

[Diagnosis of the acute injuries of the lateral ankle joint ligaments with a new holding device (author's transl)].

In one year 437 patients with acute injuries of the ligaments of the lateral ankle joint were examined with a new simple holding device to ensure accurate diagnosis. The rupture is demonstrated by standardized and reproducible stress X-rays. Comparing the instability of the injured side with the contralateral health ankle joint the difference indicates the type and the extent of the injury. In 232 cases (53%) we found a "sprained ankle" and in 205 cases (47%) ruptured ligaments.

Ankle Injuries↗
PubMed2005

Kinematics of the ankle joint complex in snowboarding.

Because snowboarders are known to injure their ankles more often than Alpine skiers, it has been postulated that stiffer snowboard boots would provide better protection to the ankle than current soft boots do. Snowboarders are also known to injure their front ankle more often than their back ankle, presumably because of the asymmetrical rotations of the ankles due to asymmetrical binding adjustement. To test these hypotheses, we measured the kinematics of the feet and legs of 5 snowboarders wearing soft boots and stiffer step-in boots during snowboarding maneuvers using an electromagnetic motion tracking system. The results were expressed in anatomically relevant rotations of the ankle joint complex, namely dorsi-/plantar flexion, eversion/inversion, and internal/external rotation. The measured ankle rotations show differences in the movement patterns of the front and back legs. Step-in boots were shown to allow less dorsiflexion, eversion, and external rotation than softer boots, possibly explaining why they are associated with a lower rate of fractures of the talus than soft boots.

Adult↗
PubMed1988

Ankle joint urate arthritis in rats provides a useful tool for the evaluation of analgesic and anti-arthritic agents.

Arthritis was induced in ether anesthetised rats by injecting 1.25 mg of sodium urate crystals into the ankle joint. Twenty-four hr after the injection the ankle is swollen and the animal does not place full weight on the affected foot. The ankle is more sensitive than normal to movement and pressure. Responses to stimulation of the foot and toes on the arthritic limb are reduced due to a reluctance to move the affected limb. These measures, which reflect ongoing pain, hyperalgesia or tenderness and guarding, are attenuated in animals treated with dexamethasone, phenylbutazone, and morphine, as well as in animals whose nerves to the ankle had been pretreated with capsaicin. Guanethidine and colchicine failed to influence the behavioural responses to the urate injection. Ankle joint urate arthritis has advantages over other models of arthritis for therapeutic testing in that in a short time it affects a single joint in rats, and it produces responses which can be assessed by simple, sensitive measures.

Analgesics↗
PubMed1979

[Arthroplasty of the upper ankle joint. Possibilities and limitations].

It is out of the question that alloarthroplasty of the upper angle joint must today belong to the therapeutic repertoire of the orthopedic surgeon. The anatomical situation of the upper ankle joint brings considerable problems for the total replacement and then also for the surface replacement. At the time being models are already available, which, seen on the whole, have already brought quite reliable results. Requirement for the success of the operation is the technically perfect insertion of the surface replacement or of the total joint and furthermore the insertion of the replacement under appropriate conditions, whereby the operation in an aseptive room ("Reinraum") has proven itself effective also on the upper ankle joint.

Air Pollution↗
PubMed1985

Three-dimensional imaging of the ankle joint from computerized tomography.

A computer system was developed to rapidly reconstruct three-dimensional (3D) images of bone from computerized tomography scans of the ankle joint. Solid models of the bones were produced from the 3D image data through the use of a computer numerically controlled milling machine. A cadaver ankle joint was scanned, and models of the distal tibia and fibula and dome of the talus were made and compared to the actual bone specimens. The measurements of the models were within 3 mm or less of the bones in all three planes (average, 1.2 mm or 5.5%). These 3D images and models of bone should allow better visualization of joint pathology and a system for preoperative planning on exact bone models to optimize the results of surgery.

Ankle Joint↗
PubMed2002

[Technique and value of arthrosonography in rheumatologic diagnosis--3: Ultrasound diagnosis of the ankle joint, foot and toes].

The clinical investigation of ankles, feet, and toes is frequently equivocal in rheumatology. Sonography can distinguish between underlying pathologies. We suggest following standard scans: 1) anterior longitudinal scan to diagnose effusions in the ankle and talonavicular joints, to display erosive and osteoarthrotic pathologies, and to diagnose tenosynovitis of the extensor tendons; 2) anterior transverse scan to document the findings in an additional dimension; 3) lateral transverse scan and 4) lateral longitudinal scan to diagnose tenosynovitis of the peroneus tendons; 5) medial transverse scan and 6) medial longitudinal scan to diagnose tenosynovitis of the flexor tendons; 7) posterior longitudinal scan and 8) posterior transverse scan to evaluate the Achilles tendon, the retrocalcaneal bursa, and the posterior recess of the ankle joint. Additionally we suggest optional scans: 9) plantar longitudinal scan for the plantar fascia and the plantar calcaneal surface; 10) distal anterior longitudinal scan to evaluate the midtalar joints; 11) distal anterior longitudinal scan to evaluate the toes; and 12) plantar, distal transverse scan to evaluate the flexor tendons of the toes. Additionally, the correlating longitudinal and transverse scans can be used to confirm the findings. The frequency of the transducer should be about 7.5 MHz for ankles and the peroneus, flexor, and extensor tendons. Ten to over 20 MHz are possible for more superficially located structures. Using modern equipment with higher resolution a hypoechoic border may be normal up to 3 mm in the ankle joints, the MTP joints, and around the peroneus tendons, and up to 4 mm around the tibialis posterior tendons.

Ankle Joint↗
PubMedDate not supplied

The effect of external ankle support in chronic lateral ankle joint instability. An electromyographic study.

We examined the effect of ankle taping on ankle joint stability by measuring mechanical stability using standardized stress radiographs. Anterior talar translation and talar tilt, both with and without ankle tape, were examined. The reduction of anterior talar translation and talar tilt with tape as compared to without tape was insignificant. The reaction time of the peroneus muscles was measured by electromyographic signal after a simulated ankle sprain on a tilting trapdoor. The reaction time was significantly slower in the unstable ankles of 20 athletes with unilateral ankle instability than in the stable contralateral ankles. With tape, the reaction time was significantly shortened, although not back to normal. The greatest improvement in reaction time was achieved in ankles with the highest degree of mechanical instability. Thus, the mechanism behind the function of ankle tape may be to restrict the extremes of ankle motion and to help shorten the reaction time of the peroneus muscles by affecting the proprioceptive function of the ankle.

Adult↗
PubMed2001

Effect of localized muscle fatigue on vertical ground reaction forces and ankle joint motion during running.

The purpose of this study was to examine the changes in the vertical ground reaction force (VGRF) and ankle joint motion during the first 50% of the stance phase of running following fatiguing exercise of either the dorsiflexors or the invertors of the foot. VGRFs, sagittal and rearfoot kinematic data were collected from 11 female recreational runners running at 2.9 m/second on a treadmill prior to and following localized muscle fatigue of either the invertors or dorsiflexors of the right foot. Loading rate of the impact peak force significantly increased following fatiguing exercise of the dorsiflexors, while the peak magnitudes of the impact and push-off forces remained unchanged. There were significant decreases in dorsiflexion at heel contact, but no significant difference in any rearfoot motion parameters tested following dorsiflexor fatigue. Following fatiguing exercise of the invertors, impact peak magnitude, push-off peak magnitude and the rate of decline of the impact peak force significantly decreased; there was no change in the loading rate of the impact peak force. Invertor fatigue also resulted in a less inverted foot position at heel contact, but there were no significant differences in any other kinematic parameters tested. The results demonstrate that localized muscle fatigue of either the invertors or dorsiflexors can have a significant effect on the loading rates, peak magnitudes and ankle joint motion seen during running. These changes, due to localized muscle fatigue, may play a role in many common lower extremity running injuries.

Adult↗
PubMed2002

Dynamic simulation of the natural and replaced human ankle joint.

Disappointing results for total ankle replacement have been explained by poor knowledge of the mechanics of the intact and replaced joints. Dynamic simulation tools have the capacity to simulate dynamic conditions that occur in human joints. The Working Model 2D tool was used to simulate the mechanics of the intact and replaced ankle joints, based on previously validated mathematical models. Elementary objects were used to model ligaments, articular surfaces, retinacula and muscle-tendon units. The performance of several pairs of prosthetic articular surfaces was also analysed. According to the results of these simulations, rolling as well as sliding motion occurs in the natural ankle, governed by a ligamentous linkage. Elongation of the tibiocalcaneal and calcaneofibular ligaments was found to be 1.5% and 4.8%, respectively. A 13% change in lever arm length occurred for both the tibialis anterior and gastrocnemius muscles during ankle flexion. Unlike the currently available three-component designs, the newly proposed convex-tibial ligament-compatible prosthesis was found to be able to restore the original mobility and physiological function of the ligaments. This prosthesis combines freedom from restraint with congruity of the components throughout the range of flexion.

Ankle Joint↗
PubMed2004

Decreased stiffness at the ankle joint in patients with long-term Type 1 diabetes.

AIMS: To evaluate contractile and reflex properties of the soleus muscle together with ankle joint stiffness in long-term Type 1 patients. METHODS: Stretch reflex and muscle function of the soleus muscle was tested in 15 Type 1 diabetes mellitus patients and 15 controls. M-wave amplitude and maximal twitch torque was elicited by supramaximal stimulation of the tibial nerve. The stretch reflex was elicited by a 4 degree rotation of the ankle. RESULTS: Rise time and fall time of the maximal twitch torque were increased compared with controls. The amplitude of the short latency stretch reflex was significantly reduced in patients at contraction levels of 5-30 Nm. At a contraction level of 5 Nm the median stretch reflex threshold was 10 degrees/s in patients and 6 degrees/s in controls (P = 0.03). Stiffness was decreased in diabetic patients, especially at lower contraction levels. There was no significant correlation between the clinical neuropathy score and stiffness. In contrast, high neuropathy score was correlated with low amplitude of the reflex amplitude (rho = -0.51, P = 0.05). CONCLUSIONS: We demonstrate altered contractile properties, a decrease in stretch reflex of the soleus muscle, and a reduced stiffness at the ankle joint in patients with long-term Type 1 diabetes. These changes may cause delayed muscle contraction and impaired reflex modulation which could contribute to gait disturbances and increased number of falls in diabetic patients.

Adult↗