Distal fibular malrotation and lateral ankle contact characteristics.

MedStar author(s):
Citation: Journal of Foot & Ankle Surgery. 25(1):90-93, 2019 Feb.PMID: 29409299Institution: Medstar Union Memorial HospitalDepartment: Orthopaedic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Ankle Injuries/pp [Physiopathology] | *Ankle Joint/pp [Physiopathology] | *Bone Plates | *Fibula/pp [Physiopathology] | *Range of Motion, Articular/ph [Physiology] | Aged | Aged, 80 and over | Ankle Injuries/di [Diagnosis] | Ankle Injuries/su [Surgery] | Ankle Joint/dg [Diagnostic Imaging] | Ankle Joint/su [Surgery] | Cadaver | Female | Humans | Male | Middle Aged | PressureYear: 2019Local holdings: Available online through MWHC library: 2003 - present, Available in print through MWHC library:1999-2007ISSN:
  • 1268-7731
Name of journal: Foot and ankle surgery : official journal of the European Society of Foot and Ankle SurgeonsAbstract: BACKGROUND: Any amount of malreduction of the syndesmotic joint compared with the uninjured syndesmosis has been associated with an adverse effect on functional outcome. The amount of malrotation that may lead to clinically relevant pressure change in this joint has not been reported. Our purpose was to determine whether small degrees of external and internal malrotation would be associated with statistically significant changes in contact pressure in the tibiofibular and talofibular articulations.CONCLUSION: Any degree of distal fibular external rotation significantly reduced contact pressure in the talofibular articulation with plantarflexion. A minimal increase in contact pressure was found in the tibiofibular and talofibular joints with plantarflexion and mild internal rotation of 5degree, but pressure increased significantly in both articulations with 10degree of internal rotation. The findings support clinical findings that subtle degrees of fibular malrotation may be associated with alteration of lateral ankle mechanics.Copyright (c) 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.LEVEL OF EVIDENCE: Controlled biomechanical study.METHODS: Twelve cadaveric ankles were osteotomized above the syndesmosis and instrumented with a rotatable distal fibula plate. Sensors at the distal tibiofibular and talofibular articulations recorded contact pressure and area at neutral position and at 5 and 10degree of external and internal malrotation through a full range of ankle motion.RESULTS: Compared with neutral rotation, there was a significant decrease in contact pressure at the talofibular articulation with external rotation of 5degree (103+/-113kPa versus 52+/-69kPa; P=0.01) and 10degree (43+/-62kPa; P=0.01) in plantarflexion.Contact pressure at the tibiofibular articulation in plantarflexion increased with 10degree of internal malrotation compared with neutral rotation (56+/-30kPa versus 74+/-38kPa; P=0.05) in plantarflexion. Contact area decreased significantly with plantarflexion and 10degree of external rotation and increased significantly in plantarflexion and after cyclic loading with 10degree of internal rotation (P<=0.05).All authors: DeFontes K, Guyton GP, Paez A, Parks B, Stroh DAFiscal year: FY2019Fiscal year of original publication: FY2018Digital Object Identifier: Date added to catalog: 2018-02-20
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 29409299 Available 29409299

Available online through MWHC library: 2003 - present, Available in print through MWHC library:1999-2007

BACKGROUND: Any amount of malreduction of the syndesmotic joint compared with the uninjured syndesmosis has been associated with an adverse effect on functional outcome. The amount of malrotation that may lead to clinically relevant pressure change in this joint has not been reported. Our purpose was to determine whether small degrees of external and internal malrotation would be associated with statistically significant changes in contact pressure in the tibiofibular and talofibular articulations.

CONCLUSION: Any degree of distal fibular external rotation significantly reduced contact pressure in the talofibular articulation with plantarflexion. A minimal increase in contact pressure was found in the tibiofibular and talofibular joints with plantarflexion and mild internal rotation of 5degree, but pressure increased significantly in both articulations with 10degree of internal rotation. The findings support clinical findings that subtle degrees of fibular malrotation may be associated with alteration of lateral ankle mechanics.

Copyright (c) 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

LEVEL OF EVIDENCE: Controlled biomechanical study.

METHODS: Twelve cadaveric ankles were osteotomized above the syndesmosis and instrumented with a rotatable distal fibula plate. Sensors at the distal tibiofibular and talofibular articulations recorded contact pressure and area at neutral position and at 5 and 10degree of external and internal malrotation through a full range of ankle motion.

RESULTS: Compared with neutral rotation, there was a significant decrease in contact pressure at the talofibular articulation with external rotation of 5degree (103+/-113kPa versus 52+/-69kPa; P=0.01) and 10degree (43+/-62kPa; P=0.01) in plantarflexion.Contact pressure at the tibiofibular articulation in plantarflexion increased with 10degree of internal malrotation compared with neutral rotation (56+/-30kPa versus 74+/-38kPa; P=0.05) in plantarflexion. Contact area decreased significantly with plantarflexion and 10degree of external rotation and increased significantly in plantarflexion and after cyclic loading with 10degree of internal rotation (P<=0.05).

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