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Biomechanical analysis of the ankle anterior drawer test for anterior talofibular ligament injuries
Author(s) -
Tohyama Harukazu,
Beyn Bruce D.,
Renström Per A.,
Theis Maureen J.,
Fleming Braden C.,
Pope Malcolm H.
Publication year - 1995
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.1100130417
Subject(s) - anterior talofibular ligament , ankle , plantar flexion , flexibility (engineering) , displacement (psychology) , anatomy , ligament , orthodontics , biomechanics , medicine , ankle sprain , mathematics , psychology , statistics , psychotherapist
The effect of sectioning the anterior talofibular ligament on the load‐displacemnt behavior of the ankle was evaluated in vitro during the anterior drawer test using the flexibility approach. Controlled forces were applied across the ankle joint in the anterior‐posterior direction, and the resulting displacements were measured at four flexion angles (10° of dorsiflexion, neutral, and 10° and 20° of plantar flexion). The anterior talofibular ligament then was sectioned, and the anterior‐posterior loadings were repeated at the four flexion angles. Two parameters were developed to describe the nonlinear load‐displacemnt response of the ankle joint: neutral zone laxity (joint displacement between ± 2.5 N) and flexibility (a measure of the nonlinear load‐displacement response of the ankle between 10 and 50 N of anterior drawer loading). After sectioning the anterior talofibular ligament, significant increases in neutral zone laxity were observed at all angles of ankle flexion. The largest increases in neutral zone laxity were found with the ankle in 10° of plantar flexion (76.3% increase) and 20° of plantar flexion (89.7% increase). After sectioning the ligament, a significant increase (19.3%) in flexibility of the ankle was observed at 10° of dorsiflexion, but no change in flexibility was observed with the ankle in the neutral and plantar flexed positions. These findings indicate that anterior drawer testing of the anterior talofibular ligament‐deficient ankle between 10° and 20° of plantar flexion results in the largest increase in neutral zone laxity compared with the normal ankle with intact ligaments. They also suggest that an excessive magnitude of force during clinical application of the anterior drawer examination may not be needed to diagnose disruption of the anterior talofibular ligament.