Ankle Joint Pressure in Supination-External Rotation Injuries: A Biomechanical Study in an Unrestrained Cadaver Model.

Fösel, Andreas C.; Seidel, Angela; Attinger, Marc C.; Zderic, Ivan; Gueorguiev, Boyko; Krause, Fabian G. (2020). Ankle Joint Pressure in Supination-External Rotation Injuries: A Biomechanical Study in an Unrestrained Cadaver Model. (In Press). Foot & ankle specialist - FAS, p. 1938640020950183. Sage 10.1177/1938640020950183

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BACKGROUND

Previous biomechanical studies simulating supination-external rotation (SER) IV injuries revealed different alterations in contact area and peak pressure. We investigated joint reaction forces and radiographic parameters in an unrestrained, more physiological setup.

METHODS

Twelve lower leg specimens were destabilized stepwise by osteotomy of the fibula (SER II) and transection of the superficial (SER IVa) and the deep deltoid ligament (SER IVb) according to the Lauge-Hansen classification. Sensors in the ankle joint recorded tibio-talar pressure changes with axial loading at 700 N in neutral position, 10° of dorsiflexion, and 20° of plantarflexion. Radiographs were taken for each step.

RESULTS

Three of 12 specimen collapsed during SER IVb. In the neutral position, the peak pressure and contact area changed insignificantly from 2.6 ± 0.5 mPa (baseline) to 3.0 ± 1.4 mPa (SER IVb) (P = .35) and from 810 ± 42 mm2 to 735 ± 27 mm2 (P = .08), respectively. The corresponding medial clear space (MCS) increased significantly from 2.5 ± 0.4 mm (baseline) to 3.9 ± 1.1 mm (SER IVb) (P = .028).The position of the ankle joint had a decisive effect on contact area (P = .00), center of force (P = .00) and MCS (P = .01).

CONCLUSION

Simulated SER IVb injuries demonstrated radiological, but no biomechanical changes. This should be considered for surgical decision making based on MCS width on weightbearing radiographs.

LEVELS OF EVIDENCE

Not applicable. Biomechanical study.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Fösel, Andreas Christian; Seidel, Angela; Attinger, Marc Claudio and Krause, Fabian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1938-7636

Publisher:

Sage

Language:

English

Submitter:

Kathrin Aeschlimann

Date Deposited:

04 Dec 2020 14:53

Last Modified:

05 Dec 2020 01:35

Publisher DOI:

10.1177/1938640020950183

PubMed ID:

32875824

Uncontrolled Keywords:

biomechanical care comparative diagnostic studies external and internal fixation trauma unstable ankle

URI:

https://boris.unibe.ch/id/eprint/149051

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