A Study of Ruptures of the Lateral Ligament of the Ankle Joint (Clinical Experience and Cadaver Studies)

足踝外側韌帶斷裂實驗報告

金學志(Hsueh-Chih King) ； 楊楚俊(Peter Tsu-Chung Yang) ； 劉建麟(Zeng-Lin Liu) ； 楊大中(Dah-Jung Yang)

《Journal of Orthopaedic Surgery Taiwan》 5卷3期 (1988/09) Pp. 208-219

摘要

臨床上較不易診斷足踝外側韌帶斷裂，而傳統性的加壓測試法”STRESS FILM”在技術上缺乏科學依據，故本院利用特殊加壓測驗器”SCHEUBA-FIZATION DEVICE”補助其中偏差，並提高其診斷率。
本報告除實驗證實足踝加壓測驗在診斷韌帶斷裂的準確性外，同時亦了解單個韌帶斷裂后（如前腓距韌帶ANTERIOR-TALOFIBULAR LIG ，腓跟韌帶Calcaneob:bular LIG，后腓距韌帶POSTE-RIOR Talofibular LIG）在解剖學以及生物力學上獨特影響及現象，將所有實驗資料化分析，並設定足踝外側韌帶斷裂后在X-光所表現的不同夾角，以助於臨床上依據。
經一系列生物力學實驗得知以下兩點：
第一點；前腓距韌帶（ATF Lig）斷裂時距腓夾角必會變大〝大約10度左右〞，若併有腓跟（CF Lig）韌帶或后腓距（PTF Lig）等斷裂其夾角更大。
第二點：當前腓距韌帶（ATF Lig）正常而腓跟韌帶（CF Lig）斷裂或併有后腓距韌帶PTF Lig斷裂等情況時則其距腓角不變。
由以上結果了解足踝外側韌帶中，前腓距韌帶扮演極重要之角色。

並列摘要

This sutdy reports the normal value of the ankle stress roentgenogram in 20 volunteers after a lateral and ventral maximum pressure of 15 KP by the Scheuba-Fixation device. The results of talar tilt angle of supination inversion stress test is 2 degrees, and talofibular gap is 5.4mm. The results of posterior hiatus of lateral sagittal stress test is 5.5mm and talotibia length is 38mm. Those data can be served as basic clinical documentation. We also report on a biomechanical study of cadavers; (10 cadacers, 20 ankles), All cadavers were divided into two groups. Group I follows a complete rupture of anterior talofibular ligament (ATF) with additional division of the rest lateral ligaments. The results demonstrated that roentgenogram of ankle joint may increased by supplementary division of lateral ligament. However, group II isolated division of two different lateal ligaments under intact anterior talofibular ligament (ATF) demonstrated that realease of calcaneofibular or posterior talofibular ligaments cannot be visualized in stress film. Therefore, results of cadaver study indicate that anterior talofibular ligament play a very important role in ankle joint stability.

並列關鍵字

Ankle Joint ； Anterior Talofibular Ligament (ATF) ； Calcaneofibular Ligament (CF) ； Posterior Talofibular Ligament (PTF)