Biomechanical Analysis of the Individual Ligament Contributions to Syndesmotic Stability

Clanton, Thomas O.; Williams, Brady T.; Backus, Jonathon D.; Dornan, Grant J.; Liechti, Daniel J.; Whitlow, Scott; Saroki, Adriana J.; Turnbull, Travis Lee; LaPrade, Robert F.

doi:10.1177/1071100716666277

Cited by 95 publications

(100 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Non‐weightbearing and weightbearing (85 kg; determined from the average of specimen donor anthropometrics) CT scans with and without application of 10 Newton meter (Nm) internal torque applied at the Ilizarov apparatus (corresponding to external torque of the foot and ankle) were collected . Ten Nm torque was chosen for consistency with cadaver studies testing the stability of the distal tibial syndesmosis . Preconditioning of the specimen was performed by consistent loading of the frame with 42.5 and 85 kg for 2 min each before experimentation.…”

Section: Methodsmentioning

confidence: 99%

“…Non-weightbearing and weightbearing (85 kg; determined from the average of specimen donor anthropometrics) CT scans with and without application of 10 Newton meter (Nm) internal torque applied at the Ilizarov apparatus (corresponding to external torque of the foot and ankle) were collected. 27 Ten Nm torque was chosen for consistency with cadaver studies testing the stability of the distal tibial syndesmosis. 27,28 JOURNAL OF ORTHOPAEDIC RESEARCH ® NOVEMBER 2019 The radiolucent frame (polyoxymethylene, an engineering thermoplastic providing high stiffness, low friction, and dimensional stability [Delrin™]) used to hold the Ilizarov apparatus consisted of a base plate and four pillars located lateral to the foot.…”

Section: Experimental Settingmentioning

confidence: 99%

“…27 Ten Nm torque was chosen for consistency with cadaver studies testing the stability of the distal tibial syndesmosis. 27,28 JOURNAL OF ORTHOPAEDIC RESEARCH ® NOVEMBER 2019 The radiolucent frame (polyoxymethylene, an engineering thermoplastic providing high stiffness, low friction, and dimensional stability [Delrin™]) used to hold the Ilizarov apparatus consisted of a base plate and four pillars located lateral to the foot. This allowed the Ilizarov apparatus to rotate in a concentric cylinder when torque was applied.…”

Section: Experimental Settingmentioning

confidence: 99%

See 2 more Smart Citations

Can Weightbearing Computed Tomography Scans Be Used to Diagnose Subtalar Joint Instability? A Cadaver Study

Krähenbühl

Burssens

Davidson

et al. 2019

Journal Orthopaedic Research

View full text Add to dashboard Cite

Chronic hindfoot instability is a frequent problem that includes the ankle and/or the subtalar joint. While ankle joint instability can be diagnosed clinically, accurate assessment of the subtalar joint remains elusive. This study's purpose was to assess the ability of weightbearing computed tomography (CT) scans to detect subtalar joint instability. Seven pairs of fresh frozen male cadavers (tibial plateau to toe‐tip) were tested. A radiolucent frame held specimens in a plantigrade position while non‐weightbearing and weightbearing CT scans (with and without torque application) were taken. First, intact ankles (Native) were scanned. Second, one specimen from each pair underwent interosseous talo‐calcaneal ligament (ITCL) transection, while the contralateral underwent calcaneo‐fibular ligament (CFL) transection. Third, the remaining intact ITCL or CFL was transected. Finally, the deltoid ligament was transected in all ankles. Eight radiographic measurements were performed to assess the congruency of the subtalar joint on digitally reconstructed radiographs and single CT images. Axial loading did not impact most measurements, whereas torque did impact most measurements. Radiographic measurements performed at the subtalar joint level were more reliable and better predictors for subtalar joint instability compared with measurements performed at the ankle joint level. While torque application is crucial to identify subtalar joint instability, axial load application should be avoided. Measurements to assess the subtalar joint stability should primarily be performed at the subtalar joint level rather than at the ankle joint level when using weightbearing CT scans. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2457–2465, 2019

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Experimental Settingmentioning

confidence: 99%

Section: Experimental Settingmentioning

confidence: 99%

See 1 more Smart Citation

Can Weightbearing Computed Tomography Scans Be Used to Diagnose Subtalar Joint Instability? A Cadaver Study

Krähenbühl

Burssens

Davidson

et al. 2019

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…This stability at the distal tibiofibular joint results from the syndesmotic ligaments. 8,38 The distal tibiofibular syndesmosis can be divided into segments by location and attachments, and include the anteriorinferior tibiofibular ligament, the posterior-inferior tibiofibular ligament (PITFL), the interosseous ligament, and the transverse ligament ( Figure 1). In posterior malleolar injuries, the transverse ligament and PITFL are frequently attached to the posterior fracture fragment.…”

Section: Relevant Anatomymentioning

confidence: 99%

Anatomy, Classification, and Management of Ankle Fractures Involving the Posterior Malleolar Fragment: A Literature Review

Bergman

Morin

Lawson

2019

Foot & Ankle Orthopaedics

View full text Add to dashboard Cite

The posterior malleolar fragment is frequently involved in rotational ankle fractures, but diagnosis and definitive management remains controversial. Ankle fractures with a posterior malleolar component that are not identified and treated in a timely manner may contribute significantly to future comorbidities, including continued pain, instability, and the development of arthritis. This article highlights the anatomic features of posterior malleolar ankle fractures, the classification schemes used, and discusses the various nonsurgical and surgical methods currently used. Level of Evidence: Level V, expert opinion.

show abstract

“…Posteriormente, se han desarrollado más trabajos en los que se aplican fuerzas de rotación y cargas más parecidas a las fisiológicas (3) . Clan-ton et al (3) analizaron la contribución relativa de los 3 ligamentos más importantes de la sindesmosis (anterior, posterior e interóseo) respecto de la estabilidad rotacional. El mecanismo de lesión más típico de la sindesmosis fue el provocado por una rotación externa y un momento de dorsiflexión forzada del tobillo.…”

Section: Biomecánica De Los Ligamentosunclassified

Biomecánica de la sindesmosis

Martínez-de-Albornoz-Torrente¹,

Monteagudo-de-la-Rosa²

2019

MACT

View full text Add to dashboard Cite

Este es un artículo Open Access bajo la licencia CC BY-NC-ND (www.creativecommons.org/licenses/by-nc-nd/4.0/). FS Introducción La sindesmosis es una articulación que proporciona estabilidad y flexibilidad a la mortaja del tobillo. Tiene la peculiaridad de funcionar como un estabilizador dinámico del complejo tibio-peroneo-astragalino. Este concepto de estabilizador dinámico es importante y el conocimiento global de las propiedades biomecánicas de la sindesmosis sana y patológica proporciona un fundamento objetivo para un mejor diagnóstico, tratamiento y rehabilitación. Se trata de un tema que todavía los cirujanos ortopédicos tenemos pendiente. De aquí el interés creciente en los últimos años, que se traduce con el aumento exponencial de publicaciones al respecto: 16 publicaciones de media anual entre los años 1998 y 2012, y 60 publicaciones de media anual entre los años 2013 y 2018 (https://www.ncbi.nlm.nih.gov/pubmed). Anatomía mecánica La estabilidad en carga de la articulación del tobillo y de la sindesmosis se atribuye en parte a: 1) La anatomía ósea distal de la tibia y el peroné: "incisura tibiofibular". 2) La estabilidad ligamentosa de los 3 principales ligamentos: ligamento tibiofibular anterior e inferior (LTFAI), ligamento interóseo tibiofibular (LTFI) y las fibras superficiales y profundas (también conocido como ligamento transverso) del ligamento tibiofibular posterior e inferior (LTFPI). Existe una transición anatómica gradual de la membrana interósea (MIO) al ligamento interóseo, e incluso del LTFI y los ligamentos inferiores anterior y posterior tibiofibulares (LTFAI y LTFPI).

show abstract

Biomechanical Analysis of the Individual Ligament Contributions to Syndesmotic Stability

Abstract: This study defined normal motion of the syndesmosis and the biomechanical consequences of injury. The degree of instability was increased with each additional injured structure; however, isolated injuries to the AITFL alone may lead to significant external rotary instability.

Cited by 95 publications

References 41 publications

Can Weightbearing Computed Tomography Scans Be Used to Diagnose Subtalar Joint Instability? A Cadaver Study

Can Weightbearing Computed Tomography Scans Be Used to Diagnose Subtalar Joint Instability? A Cadaver Study

Anatomy, Classification, and Management of Ankle Fractures Involving the Posterior Malleolar Fragment: A Literature Review

Biomecánica de la sindesmosis

Contact Info

Product

Resources

About