Abstract:

Objective　To study the effects of different surgical procedures of clinical treatment of the three-column injury of ankle on the peak contact pressure in the tibiotalarjoint.    Methods    Six fresh cadaveric adult ankles were used for creation of 3 models of different surgical proceduresof treatment for the three-column injury of ankle. In model A, the medial and lateral ligaments of ankle joint were intact(repaired), the broken inferior tibiofibular ligament were not fixed. In model B, the medial and lateral ligaments of ankle joint were intact(repaired),the broken inferior tibiofibular ligament was fixed by a screw. In model C, lateral ligaments of ankle joint were intact(repaired), the broken inferior tibiofibular ligament was fixed by a screw, but the broken medial ligaments were not repaired. The three groups were tested in order A、B、C. The 3 models were tested with an electronic pressure sensor in  a BOSE material testing machine, respectively, in 5 positions. The peak values of the compressive stresses of the 3 models in 5 positions were recorded. All  data were collected and analyzed using SPSS22.0.    Results    Model B exhibited the smallest average stress in all 5 positions, followed by model C and model A, with significant differences between B and A groups (P＜0.05）.There were significant differences between B  and C groups (P＜0.05）at 10° dorsal extension and 10°valgus position.  Conclusion  The surgical management of the three-column injury of ankle where the medial and lateral ligaments are intact or repaired, and the tibiofibular syndesmosisis effectively fixed can reduce the peak contact pressure in the tibiotalar joint.

Key words:  Ankle joint, Ligament , Biomechanics, Surgical procedures