title: Posterolateral ankle ligament injuries affect ankle stability: a finite element study.
abstract: BACKGROUND
  We have already discovered 23 patients during the work of the outpatient department and operations whose unstable signs on the posterolateral ankle. The anterior drawer test demonstrated normal during the physical examinations while the spaces of the posterior tibiotalar joints increased in stress X-ray plain films. ATFL intact and posterolateral ligaments lax were found during operations too. It is important to make existence claims and illuminate the mechanism of posterolateral ankle instability.
  
  
  METHODS
  A finite element model of the ankle was established for simulating to cut off posterolateral ligaments in turn. Ankle movements with tibia rotation under load on five forefoot positions were simulated as well.
  
  
  RESULTS
  The difference values with tibia external rotation were negative, and the positive results occurred with tibia internal rotation. The tibia-talus difference values in some forefoot positions were 2 ~ 3 mm after PTFL together with CFL or/and PITFL were cut off. The tibula-talus difference values were 2.21 ~ 2.76 mm after both PTFL and CFL were cut off. The tibia-fibula difference values were small. The difference values increased by 2 ~ 5 mm after cutting off the PITFL.
  
  
  CONCLUSIONS
  Posterolateral ankle ligaments, especially CFL and PITFL, play a significant role in maintaining ankle stability. The serious injuries of both CFL and PITFL would affect posterolateral ankle stabilities. PITFL was important to subtalar joint stability.
authors.affiliation: Orthopedics Department 3, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
authors.forename: Zhao-Jin
authors.initials: ZJ
authors.lastname: Zhu
authors.affiliation: Orthopedics Department 3, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Orthopedics Department 3, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
authors.forename: Jing-Feng
authors.initials: JF
authors.lastname: Liu
authors.affiliation: Orthopedics Department 3, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
authors.forename: Yong-Ping
authors.initials: YP
authors.lastname: Wang
authors.affiliation: Orthopedics Department 3, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.affiliation: Orthopedics Department 3, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China. xxyrjh@163.com.
authors.forename: Xiang-Yang
authors.initials: XY
authors.lastname: Xu
mesh_terms: D016512:Ankle Injuries / Q000150:complications / Q000000981:diagnostic imaging*; D000843:Ankle Joint / Q000000981:diagnostic imaging* / Q000502:physiology; D020342:Finite Element Analysis; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000209:etiology; D008023:Ligaments, Articular / Q000000981:diagnostic imaging* / Q000293:injuries* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016474:Weight-Bearing / Q000502:physiology