[Fresh ulnar rupture of the collateral ligament of the thumb saddle joint].
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In order to study the biomechanical behavior of the lateral ligaments around the ankle joint, strains on the anterior talofibular and the calcaneofibular ligaments were measured under adduction and supination loads. The amount of anterior shift of the talus was also examined under anterior "drawer" force. Specially designed omega-shaped transducers and jig sets to hold a leg and to give various loads to the foot were used for the experiments. Twenty human cadaver specimens of various ages were subjected for the study. The results showed the importance of not only the anterior talofibular ligament but also the calcaneofibular ligament as the stabilizer of the ankle joint and that the calcaneofibular ligament plays an important role in adduction, and the anterior talofibular ligament in both adduction and supination. Transection studies of the ligaments revealed that the calcaneofibular ligament is responsible to some extent for producing positive anterior drawer sign for which, as hitherto considered, the anterior talofibular ligament is the main factor.
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With a knee-testing device we measured the valgus stiffness of the medial musculoligamentous complex of the knee in five volunteers. Tests were done with the muscles quiescent and with contraction of the sartorius and vastus medialis. Contraction of those muscles substantially increased the valgus stiffness. In eight subjects the voluntary reaction times were measured. With either a visual or a tactile impulse for prophylactic muscle contraction, the muscles acted too slowly to augment the stiffness of the knee so as to prevent injury. In fifty-one volunteers we applied the maximum torque to the leg, just short of eliciting pain, and showed that even then the muscle contraction would occur too late to protect the knee in typical sports situations.
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Seventy-four ligamentous injuries of the knee in professional football players were managed without surgery during thirteen seasons of play. A success rate of 98 per cent in this group was contrasted to a success rate of 74 per cent in twenty-four patients treated with surgery in the same period. The criteria for patient selection included stability of the knee, absence of bone injury, and progressive improvement during conservative therapy. The treatment regimen avoided the use of casts and emphasized motion and exercises.
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