JOURNAL ARTICLE

Three-dimensional analysis of ankle instability after tibiofibular syndesmosis injuries: a biomechanical experimental study

Atsushi Teramoto, Hideji Kura, Eiichi Uchiyama, Daisuke Suzuki, Toshihiko Yamashita
American Journal of Sports Medicine 2008, 36 (2): 348-52
17940143

BACKGROUND: Rupture of the distal tibiofibular syndesmosis commonly occurs with extreme external rotation. Most studies of syndesmosis injuries have concentrated only on external rotation instability of the ankle joint and have not examined other defects.

HYPOTHESIS: Syndesmosis injuries cause multidirectional ankle instability.

STUDY DESIGN: Controlled laboratory study.

METHODS: Ankle instability caused by distal tibiofibular syndesmosis injuries was examined using 7 normal fresh-frozen cadaveric legs. The anterior tibiofibular ligament, interosseous membrane, and posterior tibiofibular ligament, which compose the distal tibiofibular syndesmosis, were sequentially cut. Anterior, posterior, medial, and lateral traction forces, as well as internal and external rotation torque, were applied to the tibia; the diastasis between the tibia and fibula and the angular motion among the tibia, fibula, and talus were measured using a magnetic tracking system.

RESULTS: A medial traction force with a cut anterior tibiofibular ligament significantly increased the diastasis from 1.1 to 2.0 mm (P = .001) and talar tilt angles from 9.6 degrees to 15.2 degrees (P < .001). External rotation torque significantly increased the diastasis from 0.5 to 1.8 mm (P = .009) with a complete cut; external rotation torque also significantly increased rotational angles from 7.1 degrees to 9.4 degrees (P = .05) with an anterior tibiofibular ligament cut.

CONCLUSION: Syndesmosis injuries caused ankle instability with medial traction force and external rotation torque to the tibia.

CLINICAL RELEVANCE: Both physicians and athletes should be aware of inversion instability of the ankle joint caused by tibiofibular syndesmosis injuries.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
17940143
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"