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At least 127 records · Page 7Linked to original sources
PubMed1986

[After care of surgically treated ruptures of the outer ligaments of the anterior ankle joint with special reference to the special Dr. Spring shoe].

P.o. treatment of ankle joint ligament ruptures via the special shoe "adimed-STABIL" can avoid the disadvantages of complete immobilisation with a cast. An essential condition for this type of management is the reliable prevention of extreme movements by means of this shoe, such as supination, adduction as well as maximal extension and flexion. In 10 patients with ankle joint ligament ruptures we could demonstrate that the special shoe could not fulfil these requirements, as demonstrated by stress x-rays with the correctly laced shoe under anaesthesia. Due to these results immobilisation of the ankle joint by cast after reconstruction of the ligaments appears to be the method of choice. Our observations in cases of ankle joint lesions could not confirm the fear that prolonged cast immobilisation would lead to trophic changes and would require functional physiotherapy. Because of the disadvantages of the special shoe in respect of insufficient stability, high cost, lack of ventilation and the problems involved in applying or taking off the shoe, or in remaining in "shoeless condition", we can recommend using this shoe in aftercare treatment in exceptional cases only.

Adolescent↗
PubMed1994

Technique for in vivo measurement of the three-dimensional kinematics and laxity characteristics of the ankle joint complex.

We introduce here a technique to measure the three-dimensional kinematics and laxity characteristics of the ankle joint complex in vivo. The system consists of an optoelectric, kinematic data acquisition system that is used to measure the motion of the ankle joint complex in response to controlled moments applied through a system of pneumatic actuators. As a first step toward development of the method into a quantitative diagnostic tool for injuries of ankle ligaments, we addressed the following questions: (a) What is the reliability for measurement of range of motion and laxity of the ankle joint complex? (b) Are there significant differences in laxity between the left and right joints of a healthy individual? and (c) Are there significant differences in laxity of the ankle joint complex between men and women? To answer these questions, we performed repeated measures of range of motion and laxity of paired ankles in a population of 18 healthy young individuals. The high intraclass correlation coefficients obtained from the statistical analysis indicate that the new experimental system is highly reliable in measurement of total range of motion and total laxity of the ankle joint complex. We further concluded that, within the statistical power available in our experimental design, there are no significant differences in either range of motion or laxity between left and right ankles of healthy individuals or between men and women.

Adult↗
PubMed2004

Analysis of passive motion characteristics of the ankle joint complex using dual Euler angle parameters.

OBJECTIVE: To apply the dual Euler angles method to investigate the passive motion characteristics of the human ankle joint complex. DESIGN: Three-dimensional kinematic data of the ankle joint complex was collected from 10 knee-below foot cadaver specimens. BACKGROUND: Besides the Euler angles and screw axis methods, the dual Euler angles method has been proposed as an alternative approach to quantify general spatial human joint motion. The dual Euler angles method provides a way to combine rotational and translational joint motions and to interpret motions in Cartesian coordinate systems, which can avoid the problems caused by the use of the joint coordinate system due to non-orthogonality. METHODS: A non-metal experimental setup was fabricated to generate motion in foot cadaver specimens. The kinematic data during passive dorsiflexion-plantarflexion was measured using an electromagnetic tracking device. RESULTS: The kinematic coupling characteristics and the respective contribution of the ankle joint and the subtalar joint to the gross motion of the foot with respect to the shank were analyzed based on dual Euler angle parameters. The results obtained in this study are generally in agreement with the observations reported previously. CONCLUSIONS: The dual Euler angles method is suitable for analyzing the motion characteristics of the ankle joint complex. The motion at the ankle joint complex involves rotations about and translations along three axes.

Algorithms↗
PubMed1989

[The "positioned image" of the talo-calcaneus joint in instability of the posterior distal ankle joint].

With regard to the very common disease of sprained ankles the combined tear with ruptures of ligaments of the subtalar joint are possible. Even an isolated instability is known as the reason of long lasting post-traumatic complaints. Using the apparatus of Scheuba, well-known in diagnosing instabilities of the knee and ankle joint, a new standardized method controlling instabilities of the subtalar talo-calcanear joint is introduced. In an experimental investigation this radiological technique has been tested out in cadaveric ankle joints (nine joints) with artificial ligamentous lesions. The results show that in all cases an instability is recognizable radiologically using this technique. For clinical use the bilateral examination is recommended failing standardized values for unilateral use.

Humans↗
PubMed2001

The Effects of Sex, Joint Angle, and the Gastrocnemius Muscle on Passive Ankle Joint Complex Stiffness.

OBJECTIVE: To assess the effects of sex, joint angle, and the gastrocnemius muscle on passive ankle joint complex stiffness (JCS). DESIGN AND SETTING: A repeated-measures design was employed using sex as a between-subjects factor and joint angle and inclusion of the gastrocnemius muscle as within-subject factors. All testing was conducted in a neuromuscular research laboratory. SUBJECTS: Twelve female and 12 male healthy, physically active subjects between the ages of 18 and 30 years volunteered for participation in this study. The dominant leg was used for testing. No subjects had a history of lower extremity musculoskeletal injury or circulatory or neurologic disorders. MEASUREMENTS: We determined passive ankle JCS by measuring resistance to passive dorsiflexion (5 degrees.s(-1)) from 23 degrees plantar flexion (PF) to 13 degrees dorsiflexion (DF). Angular position and torque data were collected from a dynamometer under 2 conditions designed to include or reduce the contribution of the gastrocnemius muscle. Separate fourth-order polynomial equations relating angular position and torque were constructed for each trial. Stiffness values (Nm.degree(-1)) were calculated at 10 degrees PF, neutral (NE), and 10 degrees DF using the slope of the line at each respective position. RESULTS: Significant condition-by-position and sex-by-position interactions and significant main effects for sex, position, and condition were revealed by a 3-way (sex-by-position, condition-by-position) analysis of variance. Post hoc analyses of the condition-by-position interaction revealed significantly higher stiffness values under the knee-straight condition compared with the knee-bent condition at both ankle NE and 10 degrees DF. Within each condition, stiffness values at each position were significantly higher as the ankle moved into DF. Post hoc analysis of the sex-by-position interaction revealed significantly higher stiffness values at 10 degrees DF in the male subjects. Post hoc analysis of the position main effect revealed that as the ankle moved into dorsiflexion, the stiffness at each position became significantly higher than at the previous position. CONCLUSIONS: The gastrocnemius contributes significantly to passive ankle JCS, thereby providing a scientific basis for clinicians incorporating stretching regimens into rehabilitation programs. Further research is warranted considering the cause and application of the sex-by-position interaction.

Journal Article↗
PubMed1985

[Secondary interventions following injuries of the upper ankle joint].

Fractures of the upper ankle joint require anatomic functional reposition and stabilisation in operative or conservative way. Prearthrotic alterations following inadequate treatment want secondary reconstructive measures in the early stages, whereas in manifest posttraumatic arthrosis you have to take arthrodesis as alternative treatment into consideration, which shows good results using nowadays reliable technics.

Ankle Injuries↗
PubMed2003

[Endoprosthetic replacement of the ankle joint].

Endoprosthetic replacement of the ankle joint is considered to be a modern alternative of the well-tried fusions of the joint. We try to explain indications and limits of alloarthroplasty in comparison to arthrodesis. The recent technical evolution will be presented: starting with the two-component-("first generation") and leading to the three-component ("second generation") designs, Suitable for cemented and cementless implantation as well. Results of three-component endoprostheses in the literature and our own experiences with implants of both generations especially regarding the time of survival will be discussed. Basing on the actual knowledge, we try to deduce a prognosis of the future way of ankle replacement.

Ankle Joint↗
PubMed1997

The long-term results of ankle joint synovectomy for rheumatoid arthritis.

The clinical and radiological results of synovectomy for rheumatoid arthritis in the ankle joint were investigated in 20 ankles of 15 patients. The average follow-up period after synovectomy was 15 years, ranging from 10 to 25 years. The clinical evaluation at the time of follow-up, found that only two ankles showed recurrence of synovitis, and no patient complained of severe ankle pain disturbing the activities of daily life. During the period between the synovectomy and our investigation, no patients required further surgical procedures for their ankle joints. The radiological evaluation found that in approximately two-thirds of the cases, deterioration of the radiological grade, evaluated with Larsen's criteria, had continued after synovectomy. There was no considerable radiological deterioration in the less-erosive subset patients, classified according to Ochi's criteria (1). In the unilateral synovectomized cases, using the non-operated ankles as the natural-course control, osteoarthritic changes were predominant in the operated ankle joint, and the non-operated ankle demonstrated inflammatory disease changes. These results indicate that: (1) synovectomy for a rheumatoid ankle is still a preferred treatment, lessening the clinical symptom of persistent, marked synovial proliferation resistant to medical treatment. (2) Radiological deterioration continues after synovectomy in many cases. However, a radiogram demonstrates predominant osteoarthritic destruction, which indicates the natural course of rheumatoid destruction in the operated site could be altered by synovectomy.

Adult↗
PubMed1992

[External torsion fractures of the tibia combined with ankle joint fractures].

The aim of this retrospective study is to emphasize on combined fractures of the tibia with lesions of the ankle joint. The report bases on 820 fractures of the lower leg. 123 cases showed external rotation fractures of the tibia, which were combined with lesions of the ankle joint in 88 cases. 25 patients were operated on the ankle joint. Because of the combination of external rotation fractures with lesions of the ankle joint, which accounted to 65% of the posterior tibial margin, to 17% of the lateral malleolus and to 3% of the syndesmosis, it is important to investigate the ankle joint radiologically and clinically.

Ankle Injuries↗
PubMed1995

Correlation between physical activity and the gait characteristics and ankle joint flexibility of the elderly.

The correlation between the type, duration and intensity of physical activity on the gait characteristics and the range of active ankle joint motion of the elderly were investigated in this study. Three-dimensional (3D) kinetic and kinematic assessments were performed on the normal walking patterns of 59 healthy elderly male and female subjects (aged 60-79 years). Gait analysis was performed using a high-speed video-based (3D) motion analysis system with synchronized ground-reaction force measurements. The maximal active range of motion (RoM) of the ankle joint complex of each subject was determined using an external six-degree-of-freedom flexibility assessment device. Physical activity levels were classified based on energy expenditure requirements. In general the results suggest that habitual level of physical activity did not have a significant effect on the kinetic or kinematic variables during walking, or the maximal ankle joint range of motion. Differences in ankle joint RoM and gait variables were found based on gender. No distinct benefit with respect to ankle joint range of motion or gait characteristics was provided with participation in higher-energy intensive physical activities in comparison to physical activities requiring low to moderate energy expenditures. It is speculated that the benefits of physical activity may be more pronounced in activities which demand rapid muscular strength and control movements such as recovering from a fall or obstacle avoidance. RELEVANCE: Participation in low-energy intensity activities provides the same benefits to ankle joint flexibility and locomotion, without the added risk of injury associated with high-energy intensity sports. This finding has important implications with respect to physical activity programmes for the elderly with an objective to maintain or improve independent mobility.

Journal Article↗
PubMed1986

[Post-traumatic arthrosis of the upper ankle joint in chronic insufficiency of the fibular ligament].

X-ray studies of the ankle joints of 209 patients with operatively certified ankle joint instability were examined retrospectively in order to estimate the importance of lateral instability in causing degenerative osteoarthritis of the ankle joint. The patients were distributed into two groups: group A (126 patients with chronic fibular instability; 98 were up to 29 years of age and 28 between 30 and 40 years) and group B (83 patients with a fresh fibular rupture: 70 up to 29 years and 13 between 30 and 40 years). For more subtle differentiation of the grades of osteoarthritis, a new score system was developed. The results were tested statistically. In the patients with chronic instability in the younger group signs of degenerative arthritis could be seen twice as frequently as in the recently injured patients; in particular, higher grades of arthritis were found five times more frequently than in the recently injured. All patients with chronic instability in the older group had signs of degenerative arthritis. Higher grades of degenerative arthritis occurred ten times more frequently than in the recently injured. Regarding the recently injured patients, there was no significant difference between the younger and the older group. It is concluded that chronic fibular instability is an important factor in the development of degenerative arthritis, which shows the importance of early stabilization in order to prevent the development of degenerative arthritis.

Adult↗
PubMed1999

A geometric model of the human ankle joint.

A two-dimensional four-bar linkage model of the ankle joint is formulated to describe dorsi/plantarflexion in unloaded conditions as observed in passive tests on ankle complex specimens. The experiments demonstrated that the human ankle joint complex behaves as a single-degree-of-freedom system during passive motion, with a moving axis of rotation. The bulk of the movement occurred at the level of the ankle. Fibres within the calcaneofibular and tibiocalcaneal ligaments remained approximately isometric. The experiments showed that passive kinematics of the ankle complex is governed only by the articular surfaces and the ligaments. It was deduced that the ankle is a single-degree-of-freedom mechanism where mobility is allowed by the sliding of the articular surfaces upon each other and the isometric rotation of two ligaments about their origins and insertions, without tissue deformation. The linkage model is formed by the tibia/fibula and talus/calcaneus bone segments and by the calcaneofibular and tibiocalcaneal ligament segments. The model predicts the path of calcaneus motion, ligament orientations, instantaneous axis of rotation, and conjugate talus surface profile as observed in the experiments. Many features of ankle kinematics such as rolling and multiaxial rotation are elucidated. The geometrical model is a necessary preliminary step to the study of ankle joint stability in response to applied loads and can be used to predict the effects of changes to the original geometry of the intact joint. Careful reconstruction of the original geometry of the ligaments is necessary after injury or during total ankle replacement.

Ankle Injuries↗
PubMed1997

[Effect of external stabilizing agents of the ankle joint on sports motor capacities in one legged jumping].

UNLABELLED: In order to document sport specific skills, 23 athletes with functionally unstable ankle joints as well as 18 healthy volunteers were evaluated by performing a single leg jumping test. For external stabilization of the ankle an Aircast-Brace, a Ligafix-Air-Brace, a Malleoloc-Brace as well as a tape bandage were applied. There was no negative influence on the jumping performance of the tested stabilizing devices in the uninjured ankle joints. There was also no significant difference between the devices. For functional unstable ankle joints most of the devices showed significant improvement of jumping performance. The best results were achieved by the Aircast-Brace, followed by the Malleoloc-Brace, the Ligafix-Brace and the tape bandage. Again, there was no significant difference between these devices. While the reaction time showed no difference in all test situations, the time for stabilizing the ankle joint was significantly worse in those ankle joints without a brace. CLINICAL RELEVANCE: For athletic activities, which are dominated by movement patterns comparable to the applied jumping test, the tested stabilizing devices seem to have no negative effect on sports specific capabilities.

Adult↗
PubMed1991

[Biomechanical effects of intra-articular ankle bone fractures on the ankle joint. An experimental study].

Intraarticular heelbone fractures lead to cartilage damage by way of joint surface incongruence. This causes arthrosis of the lower ankle joint. The influence of a dislocated calcaneus fracture on the upper ankle joint was documented in an experimental study on eight cadaver legs. We performed an osteotomy of the calcaneus to imitate a typical fracture, placed a pressure film into the upper ankle joint and subjected the joint to axial pressure of 850 N. Changes in contact area and pressure pattern were measured in different flexion/extension positions of the foot. Results with respect to total contact area and high-pressure contact zone are discussed.

Ankle Joint↗
PubMed2000

[Cast immobilization versus vacuum stabilizing system. Early functional results after osteosynthesis of ankle joint fractures].

In a prospective randomized trial the early functional results after immobilisation in a cast were compared to those after using a vacuum stabilizing system. The vacuum stabilizing system Vacoped offers equivalent stability compared to a plaster cast. In contrast to the cast the Vacoped can be removed for body care and physical therapy. Additionally the range of motion for dorsal flexion/extention in the upper ankle joint can be adjusted. From 9/1996 to 7/1997 there were 40 patients included in the study with an operated ankle fracture as monotrauma. Six weeks postoperatively the patients with cast treatment showed significantly higher functional deficits for the upper ankle joint (20%), the lower ankle joint (40%) and muscle atrophy (2.1 cm side difference) than the group with the vacuum stabilizing system (upper ankle joint 15%, lower ankle joint 25%, 1.4 cm muscle atrophy). Five patients out of the group with the vacuum system were already at work three weeks postoperatively. Three months postoperatively the functional results for both groups were approximating. The vacuum stabilizing system Vacoped offers better early functional results than conventional cast treatment after osteosynthesis of ankle fractures. Because of the increased patient comfort and the early ability for physical therapy the vacuum stabilizing system is preferable to cast treatment.

Adult↗
PubMed1991

[Magnetic resonance tomography of the ankle joint].

To define the clinical role of MRI of the ankle joint, a total of 88 patients was investigated. In the evaluation of ligamentous injury, MRI was inferior to established imaging methods. By contrast, it provided additional therapy-relevant information in the assessment of hemophilic arthropathy, osteochondritis dissecans, and inflammatory and neoplastic diseases of the ankle joint. In the latter conditions, MRI may make other more conventional methods of examining the ankle joint unnecessary.

Ankle Injuries↗
PubMed1979

Differential diagnosis of ruptures of the lateral ligaments of the ankle joint.

Ruptures of the lateral ligaments of the ankle joint occur very frequently in young persons and this subject is therefore one which deserves more attention. Once a fracture or avulsion of a ligamentary insertion has been excluded the nature and extent of the ligamentary lesion should be precisely assessed. The only objective criterion of rupture of a ligament is demonstrable instability of the joint. Since the anterior talo-fibular ligament is always found to be torn immediately following supination-inversion injury to the ligaments the talar drawer sign will be demonstratable both clinically and radiologically in such cases. This test causes almost no pain and can be carried out without anesthesia. The radiological visualization of ligamentary instability with the aid of a simple jig which stresses the ankle joint provides diagnostic information which is definitely superior to that obtained from an a-p roentegenogram of the stressed joint. This conclusion was reached by statistical analysis of 384 roentgenograms.

Ankle Injuries↗