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Effects of inferior tibiofibular syndesmosis injury and screw stabilization on motion of the ankle: a finite element study

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Traditional studies of syndesmosis injury and screw stabilization have been conducted in cadaveric models, which cannot yield sufficient and exact biomechanical data about the interior of the ankle. The purpose of this study was to evaluate the effects of inferior tibiofibular syndesmosis injury (ITSI) and screw stabilization on the motion of the ankle with finite element analysis.

Methods

Three-dimensional models of the ankle complex were created with CT images of a volunteer’s right ankle in three states: normal, post-ITSI, and stabilization with a screw 2.5 cm above (parallel to) the ankle. Simulated loads were applied under three conditions: neutral position with single foot standing, internal rotation, and external rotation of the ankle.

Results

Compared with the normal state, ITSI increased the relative displacement between the lower extremes of the tibia and fibula in the anteroposterior and mediolateral directions and the angular motion of the tibia, fibula, and talus at internal and external rotations (ERs). However, when stabilized with syndesmotic screws, the range of motion (ROM) and all these parameters significantly decreased.

Conclusion

ITSI can lead to internal and ER instability of the ankle joint. Screw stabilization is effective in controlling the instability, but may reduce markedly the ROM of the ankle joint. Through this study, it can be proposed that the screws should be removed once the healing is gained in order to restore normal function of the ankle joint as soon as possible.

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Acknowledgments

This work was supported by the Shaanxi Province Science Technology Research and Development Projects (No. 2011K12-05-13) and the Natural Science Foundation of China (No. 81071233). We also thank Professor Liang Allen Ping and Ms Zhang Yifang for their revision and editing of this manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Joint Surgery, Hong-Hui Hospital, Xi’an Jiaotong University College of Medicine, 76 Nanguo Road, Beilin District, Xi’an, 710054, China

    Qinghua Liu, Guanghui Zhao & Jianbin Ma

  2. Department of Orthopaedic Trauma, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China

    Bin Yu

  3. Department of Orthopaedic Trauma, Hong-Hui Hospital, Xi’an Jiaotong University College of Medicine, 76 Nanguo Road, Beilin District, Xi’an, 710054, China

    Zhong Li & Kun Zhang

Authors
  1. Qinghua Liu
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  2. Guanghui Zhao
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  3. Bin Yu
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  4. Jianbin Ma
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  5. Zhong Li
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  6. Kun Zhang
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Correspondence to Kun Zhang.

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Liu, Q., Zhao, G., Yu, B. et al. Effects of inferior tibiofibular syndesmosis injury and screw stabilization on motion of the ankle: a finite element study. Knee Surg Sports Traumatol Arthrosc 24, 1228–1235 (2016). https://doi.org/10.1007/s00167-014-3320-y

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  • DOI: https://doi.org/10.1007/s00167-014-3320-y

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