[Biomechanics, technique and results of fibular ligamentous grafting at the ankle joint (author's transl)].
The grafting operations according to Watson-Jones and Evans in old fibular capsular ligament lesions of the ankle joint have the effect of tenodesis as far as the talo-calcaneo-navicular joint ist concerned, since especially the natural course of the ligamentum calcaneofibulare, which requires substitution, is not considered. The authors conducted a search for the most favourable course when replacing the ligamenta talofibulare anterius and calcaneofibulare, using a thread model on ankle joint preparations. It is only the direct replacement of these ligaments which is most likely to ensure free mobility of ankle joint and the talo-calcaneonavicular joint with optimal joint stabilization. Courses proceeding differently will lead either to tenodesis or to slackening of the ligamentous replacement without producing a stabilizing effect. From the author's own patient, two groups with anatomically compatible ligamentous replacement with lyodura (n = 12) or with a modified graft of the short peroneal muscle (n = 8) were compared with each other. In accordance with the experimental results, the main difference between the two processes was the restriction in supination of the talo-calcaneo-navicular joint. The authors conclude from their results that duraplasty, which follows the anatomical course of the ligaments to be replaced, is indicated particularly in such patients who require free supination of the foot because they are active in certain types of sport where this is essential.
D016512:Ankle Injuries; D000843:Ankle Joint / Q000601:surgery*; D001696:Biomechanical Phenomena; D006801:Humans; D008023:Ligaments, Articular / Q000293:injuries / Q000601:surgery*; D019736:Prostheses and Implants
Biomechanik, Technik und Ergebnisse der fibularen Bandplastik am Sprunggelenk.