Premium
Effects of lateral ligament sectioning on the stability of the ankle and subtalar joint
Author(s) -
Ringleb Stacie I.,
Dhakal Ajaya,
Anderson Claude D.,
Bawab Sebastain,
Paranjape Rajesh
Publication year - 2011
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.21407
Subject(s) - subtalar joint , anterior talofibular ligament , calcaneus , ligament , ankle , tibia , kinematics , medicine , instability , cadaver , joint (building) , orthodontics , anatomy , surgery , ankle sprain , physics , mechanics , structural engineering , engineering , classical mechanics
Patients with subtalar joint instability are often diagnosed with ankle instability. Only after a prolonged period of time in which a patient does not improve after treatment for ankle instability is subtalar joint instability considered. To develop a clinically relevant method to diagnose subtalar joint instability, the kinematics of the simulated unstable subtalar joint were examined. A 6 degree‐of‐freedom positioning and loading device was developed. Plantarflexion/dorsiflexion, inversion/eversion, and internal/external rotation were applied individually or as coupled motions along with an anterior/posterior drawer. Kinematic data were collected from sensors attached to the calcaneus, talus, and tibia by keeping all the ligaments intact, and by serially sectioning anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), cervical ligament, and talocalceneal interosseous ligament. Kinematic results were reported using Euler angles. The ATFL and CFL contributed talocrural instability, similar to previous studies. The interosseous ligament was the greatest contributor to subtalar joint stability. The hindfoot motion (calcaneus relative to tibia) showed significant increases in motion when the ankle and/or subtalar joint was made to be unstable. Therefore, it is difficult to diagnose subtalar joint instability on physical examination alone. © 2011 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29: 1459–1464, 2011