The role of the medial ligaments in lateral stabilization of the ankle joint: an in vitro study

Ziai, Pejman; Benca, Emir; Skrbensky, Gobert von; Wenzel, Florian; Auffarth, Alexander; Krpo, Selma; Windhager, Reinhard; Buchhorn, T.

doi:10.1007/s00167-013-2708-4

Cited by 33 publications

(39 citation statements)

References 29 publications

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“…The Steinmann pin is then locked in a guide block attached to the platform. The guide block of the platform enables anterior‐to‐posterior motion of the hindfoot during internal rotation, allowing anterior translation of the talus . Torsion was applied by internal rotation of the tibia against the fixated calcaneus from 0° to 40° in order to simulate stresses in lateral ligaments during a vivo ankle sprain.…”

Section: Methodsmentioning

confidence: 99%

Biomechanical evaluation of different ankle orthoses in a simulated lateral ankle sprain in two different modes

Benca

Ziai

Hirtler

et al. 2019

Scandinavian Med Sci Sports

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Ankle orthoses are commonly used for prevention of recurrent ankle sprains. While there are some data on their functional performance or restriction of range of motion, there is little knowledge on the quantifiable passive mechanical effectiveness of various devices. This study aimed to determine the prophylactic stabilization effect for commonly prescribed ankle orthoses in a simulated recurrent ankle sprain. Eleven anatomic lower leg specimens were tested in plantar flexion and hindfoot inversion in a simulated ankle sprain in a quasi‐static and dynamic test mode at 0.5°/s and 50°/s internal rotation, respectively. Tests included intact specimens, same specimens with the ruptured anterior talofibular ligament (ATFL), followed by stabilization with five different semi‐rigid orthoses: AirGo Ankle Brace, Air Stirrup Ankle Brace, Dyna Ankle 50S1, MalleoLoc, and Aequi. Compared to the injured and unprotected state, two orthoses (AirGo and Air Stirrup) significantly reinforced the ankle. The Aequi ankle brace restored stability comparable to an intact joint. Dyna Ankle 50S1 and MalleoLoc provided insufficient resistance to applied internal rotation compared to the ankle with ruptured ATFL. Ankle orthoses varied significantly in their ability to stabilize the unstable ankle during an ankle sprain in both testing modes. Presented objective data on passive stabilization reveal a lack of supporting evidence for clinical application of ankle orthoses.

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Section: Methodsmentioning

confidence: 99%

Biomechanical evaluation of different ankle orthoses in a simulated lateral ankle sprain in two different modes

Benca

Ziai

Hirtler

et al. 2019

Scandinavian Med Sci Sports

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“…Verletzungen im Bereich des medialseitigen Bandapparats sind deutlich seltener als die des Außenbands [9] und werden ebenfalls bei schweren Traumen, insbesondere bei Fibulafrakturen oder Syndesmosenrupturen, und v. a. in Assoziation mit Verletzungen des Außenban-dapparats beobachtet [1][2][3]. Eine kombinierte Verletzung der medial-und lateralseitigen Strukturen kann zur Rotationsinstabilität führen [4]. Isolierte Verletzungen der Syndesmose werden in bis zu 16 % aller Sprunggelenkdistorsionen registriert [1,3,9,10].…”

Section: Verletzungsverteilungunclassified

“…Verletzungen im Bereich des medialen Bandapparats, der Syndesmose und auch der Peronealsehnen werden selten berücksichtigt, obwohl die medialen Bandstrukturen sowie die Syndesmose als passive und die Peronealsehnen als aktive und passive Stabilisatoren des Sprunggelenks bekannt sind [4,11]. [12].…”

Section: Distorsionstraumen Ist Der Laterale Bandapparat Betroffenunclassified

Erratum zu: Das instabile Sprunggelenk

2015

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“…[1][2][3][4] The superficial layer of the deltoid comprises the tibionavicular, tibiocalcaneal, and posterior tibiotalar ligaments. 3 The deep layer is larger and broader than the superficial layer and provides more reinforcement to the medial ankle.…”

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“…3 The deep layer is larger and broader than the superficial layer and provides more reinforcement to the medial ankle. 1,2,5 Primarily, the deltoid ligament limits eversion of the subtalar joint 1,3 and aids in restricting external rotation of the foot. 2 Forceful eversion causes a deltoid ligament sprain, resulting in pain, restricted ankle total range of motion, and swelling over the medial malleolus.…”

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confidence: 99%

The Epidemiology of Deltoid Ligament Sprains in 25 National Collegiate Athletic Association Sports, 2009–2010 Through 2014–2015 Academic Years

Kopec

Hibberd

Roos

et al. 2017

Journal of Athletic Training

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academic years. Deltoid ligament sprain injury rates, rate ratios, and injury proportion ratios with 95% confidence intervals (CIs) were reported.Results: During the study period, 380 deltoid ligament sprains were reported, resulting in a combined injury rate of 0.79/10 000 athlete-exposures (AEs; 95% CI ¼ 0.71, 0.87). Most deltoid ligament sprains occurred in practices (54.2%, n ¼ 206). However, the competition injury rate was higher than the practice injury rate (rate ratio ¼ 3.74; 95% CI ¼ 3.06, 4.57). The highest deltoid ligament sprain rates were in women's gymnastics (2.30/10 000 AEs; 95% CI ¼ 1.05, 3.55), men's soccer (1.73/10 000 AEs; 95% CI ¼ 1.14, 2.32), women's soccer (1.61/10 000 AEs; 95% CI ¼ 1.13, 2.09), and men's football (1.40/10 000 AEs; 95% CI ¼ 1.18, 1.62). Nearly half of all deltoid ligament sprains (49.7%, n ¼ 189) were due to player contact, and 39.5% (n ¼ 150) were non-time-loss injuries (ie, participation restricted for less than 24 hours). Only 8.2% (n ¼ 31) of deltoid ligament sprains were recurrent.Conclusions: The highest deltoid ligament sprain rates were in women's gymnastics, men's and women's soccer, and men's football. However, the rate for women's gymnastics was imprecise (ie, the CI was wide), highlighting the need for further surveillance of deltoid ligament sprains in the sport. Most deltoid ligament sprains were due to player contact. Future researchers should assess interventions that may prevent deltoid ligament sprains.Key Words: eversion sprains, medial ankle sprains, collegiate athletes Key PointsMen's football and men's and women's soccer players had the highest rates of deltoid ligament sprains. Women gymnasts also had a high rate of deltoid ligament sprains, but the cell size was small and the confidence interval was wide. Player contact was the most common mechanism of injury.

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The role of the medial ligaments in lateral stabilization of the ankle joint: an in vitro study

Cited by 33 publications

References 29 publications

Biomechanical evaluation of different ankle orthoses in a simulated lateral ankle sprain in two different modes

Biomechanical evaluation of different ankle orthoses in a simulated lateral ankle sprain in two different modes

Erratum zu: Das instabile Sprunggelenk

The Epidemiology of Deltoid Ligament Sprains in 25 National Collegiate Athletic Association Sports, 2009–2010 Through 2014–2015 Academic Years

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