TY  - BOOK
AU  - DeFontes, Kenneth
AU  - Guyton, Gregory P
AU  - Paez, Adrian
AU  - Parks, Brent
AU  - Stroh, D Alex
TI  - Distal fibular malrotation and lateral ankle contact characteristics
SN  - 1268-7731
PY  - 2019///
KW  - *Ankle Injuries/pp [Physiopathology]
KW  - *Ankle Joint/pp [Physiopathology]
KW  - *Bone Plates
KW  - *Fibula/pp [Physiopathology]
KW  - *Range of Motion, Articular/ph [Physiology]
KW  - Aged
KW  - Aged, 80 and over
KW  - Ankle Injuries/di [Diagnosis]
KW  - Ankle Injuries/su [Surgery]
KW  - Ankle Joint/dg [Diagnostic Imaging]
KW  - Ankle Joint/su [Surgery]
KW  - Cadaver
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Pressure
KW  - Medstar Union Memorial Hospital
KW  - Orthopaedic Surgery
KW  - Journal Article
N1  - Available online through MWHC library: 2003 - present, Available in print through MWHC library:1999-2007
N2  - 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)
UR  - https://dx.doi.org/10.1016/j.fas.2017.09.001
ER  -