Instability of the hindfoot after lesion of the lateral ankle ligaments: investigations of the anterior drawer and adduction maneuvers in autopsy specimens.
The mobility patterns in the tibiotalocalcaneal joint complex with a solitary lesion of the anterior talofibular ligament (ATL) and a combined lesion of the ATL and calcaneofibular ligament (CFL) were studied in 22 human lower-extremity autopsy specimens mounted in a kinesiologic testing device. A solitary lesion of the ATL increased the anteroposterior (AP) laxity in the ankle joint in the entire range of flexion, with a maximum median of 3.1 mm in neutral flexion. Further cutting of the CFL increased AP laxity most obviously in dorsiflexion. A solitary lesion of the ATL resulted in a minor instability in adduction, whereas further lesion to the CFL increased adduction in the entire range of flexion, with a maximum median of 14.2 degrees in dorsiflexion. The anterior drawer maneuver can reveal a combined lesion of the ATL and CFL if performed with the tibiotalocalcaneal joint complex in dorsiflexion. Significant clinical instability in adduction will only take place when a combined lesion of the ATL and CFL is present.
Kjaersgaard-Andersen
P
P
Biomechanics Laboratory, Orthopaedic Hospital, University of Aarhus, Denmark.
Frich
L H
LH
Madsen
F
F
Helmig
P
P
Søgård
P
P
Søjbjerg
J O
JO
D000293:Adolescent; D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology*; D008023:Ligaments, Articular / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D011199:Potentiometry; D016059:Range of Motion, Articular