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At least 379 records · Page 21Linked to original sources
PubMed1986

Pronator muscle weakness in functional instability of the ankle joint.

Functional instability, i.e., recurrent sprains or a feeling of "giving way" of the ankle, is common after ankle sprains. These patients have been supposed to have peroneal muscle weakness based on manual methods for measuring muscle strength. We have confirmed this theory by an isokinetic method for testing pronator muscle strength. Pronator muscle weakness on the affected side was found among patients with unilateral functional instability of the ankle joint. Impaired postural control was demonstrated by stabilometry with the patient standing on either foot.

Adolescent↗
PubMedDate not supplied

Valgus deformity of the ankle joint: pathogenesis of fibular shortening.

An abnormal shortening of the fibula, leading to a valgus deformity of the ankle joint, is a common finding in the paralytic ankle. This article analyzes 173 ankles in which shortened fibulae were present. Analysis of several factors that interfere with fibular growth showed that soleus strength and anatomical continuity of the fibula are important factors in the normal fibular growth. Any factor that interferes with the normal balance of forces at the distal fibula physis can cause an abnormal shortening of the fibula and lead to valgus deformity of the ankle.

Ankle Joint↗
PubMed1994

1994 William J. Stickel Gold Award. Contact characteristics of the ankle joint. Part 2. The effects of talar dome cartilage defects.

Variations in ankle joint contact characteristics caused by articular defects of the talar dome were investigated in 14 fresh-frozen cadaver specimens using pressure-sensitive film. Intact ankle and foot specimens were mounted in a materials tester on a loading frame which allowed positioning in neutral, and 20 degrees of dorsiflexion and plantarflexion. Joint contact prints were recorded while an 800 N load was axially applied through the leg. Specimens were randomly placed into two lesion groups: either anterolateral or posteromedial. During testing, each specimen had four concentrically placed lesions on the talar dome, graduated in size. Following removal, the film transducers were digitized along with pressure calibration prints. The images were analyzed quantitatively to determine contact areas, mean contact pressures, ratio of to contact plafond areas, and high pressure centroid position as a function of lesion size and location. The results demonstrated significant changes in contact characteristics for larger lesions (> or = 7.5 x 15 mm) (P < 0.05). These findings suggest that determining the size of a lesion may assist in predicting the long-term outcome of ankles with cartilage defects.

Ankle Injuries↗
PubMed1996

Valgus tilting of the ankle joint after subtalar (hindfoot) fusion: complication or natural progression of valgus hindfoot deformity?

Six patients treated over a 2-year period were noted to have valgus tilting of the talus at the ankle joint on standing anteroposterior ankle films taken after subtalar (hindfoot) fusions. All patients had significant preoperative hindfoot valgus, but no changes on ankle films. All patients underwent "moldable insitu fusions." Severity and duration of preoperative deformity, as well as obesity, appear to be predisposing factors. Most patients were satisfied with their pain relief despite their persistent valgus deformity. Treatment alternatives may include medial displacement calcaneal osteotomy, lateral column lengthening, combination bone and soft tissue procedures, or even tibial talar calcaneal fusion.

Adult↗
PubMed1996

[Screw arthrodesis of the ankle joint. Technique and outcome].

In ankle arthrodeses several clinical and biomechanical studies have shown the superiority of the screw technique over external fixation. As a maximum of stability is a major goal, especially for functional after-treatment or in patients with poor bone stock, the arthrodeses technique at Hannover Medical School is performed with four screws. Two parallel anterior/posterior screws are placed from the tibia to the talus, providing anterior stabilization. One screw posteriomedial has a posterior tension-wiring effect and one screw placed through the fibula to the talus acts against rotational and sagittal translation. From May 1975 to May 1995, 225 ankle arthrodeses with internal or external fixation technique were performed. Complications were found in 47% in the external fixation treatment group (n = 44) and in 10% the patients stabilized with the screw technique (n = 181). Fifty of these 225 patients had a follow-up evaluation after an average of 7.4 years (external fixation, n = 22; screw fixation, n = 28). All patients were examined and scored with three different scoring systems: (1) MHH Score, (2) Clinical Rating System according to Kitaoka et al. (1994) and (3) Outcome Questionnaire for evaluating the overall outcome. The results from the questionnaire were compared to the clinical scores. Retrospective analysis revealed a higher rate of complications for arthrodeses performed by external fixation. The overall results of all three different scoring systems showed a trend in favor of the screw-fixation technique without reaching statistical significance (P > 0.05). The results of the Outcome Questionnaire are statistically as valid as the two clinical scoring systems.

Ankle Joint↗
PubMed1981

[Luxation of the ankle joint without fracture (author's transl)].

Report on 3 cases of luxation in the ankle joint without fracture. It is supposed that this injury is much more frequent than generally assumed. The fundamental pathogenetics of these injuries are discussed. There was always immobilisation in a cast following operative treatment. In one case the talus was fixed additionally by a transarticular Kirschner-wire. Because of splitting, the common suture of a liagment is problematical. It is proposed to fix the ligament under a small screw.

Adult↗
PubMed1993

Effect of ankle joint position on electrically evoked surface myoelectric signals of the tibialis anterior muscle.

The relationship between surface myoelectric signal variables and ankle joint angle is studied in the tibialis anterior muscle of ten normal subjects during electrical stimulation of the main muscle motor point in isometric conditions. Rectangular current pulses of 0.1 ms width and 20Hz repetition rate were applied for 10s with a monopolar technique using a stimulation/detection system providing stimulation artifact suppression. Electrically evoked responses (M-waves) were detected with a four-bar electrode placed on the skin below the lowest motor point near the tendon end of the muscle. Average rectified value, root mean square value, mean and median spectral frequency, conduction velocity, and latency of the surface signal were computed for ankle angles of 15 degrees dorsal flexion (-15 degrees), 0 degrees, 15 degrees, 30 degrees and 45 degrees of plantar flexion. All variables were considerably affected by the joint angle. Spectral variables and latency showed a statistically significant decrement as angle increased from -15 degrees to 45 degrees whereas conduction velocity and amplitude variables had a less regular behavior. The evoked response showed a latency decrement and a change of shape (mostly a widening of the second phase), as ankle joint angle increased from -15 degrees to 45 degrees. In most subjects conduction velocity appeared to be over estimated at -15 degrees and 45 degrees, a fact attributed to the small distance between the electrodes and either the tendon or the innervation zone at these two angles.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Corrective cosmetic supramalleolar osteotomy for valgus deformity of the ankle joint: a report of two cases.

Valgus deformity of the ankle joint can cause pain in walking and a significant gait disturbance because of the altered ankle mechanics and the secondary planovalgus deformity of the foot. A technique of supramalleolar osteotomy that is cosmetically better than a closing wedge osteotomy for correction of this condition is described in two patients with hereditary multiple exostoses. The osteotomy is inherently stable, and minimal or no internal fixation is needed.

Ankle↗
PubMed2004

Ligament fibre recruitment at the human ankle joint complex in passive flexion.

Knowledge of ligament fibre recruitment at the human ankle joint complex is a fundamental prerequisite for analysing mobility and stability. Previous experimental and modelling studies have shown that ankle motion must be guided by fibres within the calcaneofibular and tibiocalcaneal ligaments, which remain approximately isometric during passive flexion. The purpose of this study was to identify these fibres. Three below-knee amputated specimens were analysed during passive flexion with combined radiostereometry for bone pose estimation and 3D digitisation for ligament attachment area identification. A procedure based on singular value decomposition enabled matching bone pose with digitised data and therefore reconstructing position in space of ligament attachment areas in each joint position. Eleven ordered fibres, connecting corresponding points on origin and insertion curves, were modelled for each of the following ligaments: posterior talofibular, calcaneofibular, anterior talofibular, posterior tibiotalar, tibiocalcaneal, and anterior tibiotalar. The measured changes in length for the ligament fibres revealed patterns of tightening and slackening. The most anterior fibre of the calcaneofibular and the medio-anterior fibre of the tibiocalcaneal ligament exhibited the most isometric behaviour, as well as the most posterior fibre of the anterior talofibular ligament. Fibres within the calcaneofibular ligament remain parallel in the transverse plane, while those within the tibiocalcaneal ligament become almost parallel in joint neutral position. For both these ligaments, fibres maintain their relative inclination in the sagittal plane throughout the passive flexion range. The observed significant change in both shape and orientation of the ankle ligaments suggest that this knowledge is fundamental for future mechanical analysis of their response to external forces.

Ankle Joint↗
PubMed1987

[Nuclear magnetic resonance tomography anatomy of the knee and ankle joints].

Soft tissue and osseous structures of joints can be differentiated by magnetic resonance tomography. Knee and ankle joints of three volunteers were systematically examined using a head coil at 1.5 Tesla and spin echo mode. Slice thickness was 5 mm. The anatomical details which could be visualized are described and directions for the most useful slices are indicated.

Adipose Tissue↗
PubMed2004

Effect of the resection of the sciatic nerve on the Th1/Th2 balance in the synovia of the ankle joint of adjuvant arthritic rats.

Inflamed synovia of the ankle joint after 2-4 weeks of adjuvant injection receives dense sensory innervation. To study the role of sensory nerves on the local inflammation, the relative expression of T helper 1 and 2 lymphocyte (Th1 and Th2) markers was investigated on both axotomized adjuvant arthritic (AA) rats, whose sciatic nerves were resected before adjuvant injection, and on sham-operated ones. Immunohistochemical expressions of CXC chemokine receptor 3 (CXCR3) and CC chemokine receptor 4 (CCR4) were examined and compared with those of Th1 cytokine (interferon-gamma, IFN-gamma), Th2 cytokine (interleukin-4, IL-4), and anti-T cell antibody (W3/25). Double-positive cells for IFN-gamma/CXCR3 and for IL-4/CCR4 were greater than 90% and greater than 95%, respectively. The reciprocal combinations, IL-4/CXCR3 and IFN-gamma/CCR4, however, yielded less than 10% and less than 5% of double-positive cells. CXCR3 and CCR4 thus appear to be available as markers for Th1/Th2 subsets in the synovia of AA rats. Using these markers, it became clear that the percentage of Th1 cells to total Th cells was higher than that of Th2 cells in axotomized AA rats at weeks 2-4, whereas in sham-operated AA rats, the percentage of Th1 cells to total Th cells was higher than that of Th2 cells at week 2 and the latter exceeded the former at week 4. Our observations strongly suggested the presence of the anti-inflammatory action of sensory nerves in rats with adjuvant arthritis.

Animals↗
PubMed1993

Effect of upper tibial osteotomy on fibula movement and ankle joint motion.

Several techniques of upper tibial osteotomy in the treatment of unicompartmental osteoarthritis of the knee have been described. Osteotomy of the fibula is normally also carried out, or alternatively, dissection of the capsule of the proximal tibiofibular joint. There is concern, however, that this latter procedure may have an adverse effect on the mobility of the ankle joint and on fibula rotation. To investigate these suspected interactions we performed experimental studies in 14 cadaver legs. The vertical, lateral and rotational movements of the fibula were measured with the ankle in neutral (0 degrees) and maximal ankle dorsiflexion before and after performing an interligamental upper tibial osteotomy of a standardised valgus wedge. Maximal ankle dorsiflexion before the osteotomy produced external rotation of the fibula in most specimens, whereas after osteotomy this movement caused mainly internal rotation. In the neutral position of the ankle, upper tibial osteotomy lead to external rotation of the fibula. The upward movement of the fibula head after osteotomy was 0.64 cm on average. There was no measurable vertical motion of the fibula during ankle dorsiflexion either before nor after upper tibial osteotomy. Ankle dorsiflexion improved minimally after osteotomy. In conclusion, this study shows that upper tibial osteotomy with dissection of the capsule of the proximal tibiofibular joint has no adverse effect on movement of the fibula or of the ankle joint. In addition, unlike fibular osteotomy, this technique also has the advantage that the risk of common peroneal nerve injury is minimal.

Ankle Joint↗
PubMed1995

Effect of maintained stretch on the range of motion of the human ankle joint.

The effectiveness of maintained stretch in expanding the range of motion of the human ankle joint was assessed in a population of normal adults. Controlled movements were imposed upon the ankle, and triceps surae and tibialis anterior electromyograms were monitored to ensure that only passive joint properties generated ankle torque. We found that a majority of subjects (7 of 12) showed evidence of muscle activity sufficient to distort a subjective assessment of changes in range of motion. For the remaining five subjects, a 60-s maintained stretch produced a small decrease in the torque subsequently generated by an imposed dorsiflexing movement, but this effect was transient and largely disappeared following 300 s of rest at a neutral position. This short-term effect is consistent with the viscoelastic properties of collagenous material stretched during such treatment and is unlikely to lead to long-term increases in range of motion. RELEVANCE: The results of these experiments indicate that subjective assessments of changes in joint range of motion may be distorted by voluntary and reflexive muscle activation. Moreover the presumed increases in range of motion produced by maintained stretch in our normal subjects were small and transient. These results suggest that future assessments of the long-term efficacy of this treatment must monitor muscle activity and take into account known viscoelastic properties of collagenous materials.

Journal Article↗
PubMed1993

Control of torque direction by spinal pathways at the cat ankle joint.

To study the biomechanics of the calcaneal tendon's complex insertion onto the calcaneus, we measured torque-time trajectories exerted by the triceps surae and tibialis anterior muscles in eight unanesthetized decerebrate cats using a multi-axis force-moment sensor placed at the ankle joint. The ankle was constrained to an angle of 110 degrees plantarflexion. Muscles were activated using crossed-extension (XER), flexion (FWR), and caudal cutaneous sural nerve (SNR) reflexes. Torque contributions of other muscles activated by these reflexes were eliminated by denervation or tenotomy. In two animals, miniature pressure transducers were implanted among tendon fibers from the lateral gastrocnemius (LG) muscle that insert straight into the calcaneus or among tendon fibers from the medial gastrocnemius (MG) that cross over and insert on the lateral aspect of calcaneus. Reflexively evoked torques had the following directions: FWR, dorsiflexion and adduction; SNR, plantarflexion and abduction; and XER, plantarflexion and modest abduction or adduction. The proportion of abduction torque to plantarflexion torque was always greater for SNR than XER; this difference was about 50% of the magnitude of abduction torque generated by tetanic stimulation of the peronei. During SNR, pressures were higher in regions of the calcaneal tendon originating from MG than regions originating from LG. Similarly, pressures within the MG portion of the calcaneal tendon were higher during SNR than during XER, although these two reflexes produced matched ankle plantarflexion forces. Selective tenotomies and electromyographic recordings further demonstrated that MG generated most of the torque in response to SNR, while soleus, LG, and MG all generated torques in response to XER.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗