Hacı Ali Olçar, Halil Burak Mutu, Alaettin Özer, Tolgahan Kuru, Davut Aydın, Murat Korkmaz
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引用次数: 0
Abstract
Background: Distal fibula fractures at the ankle level are common and are usually accompanied by ligament injuries. This study aims to evaluate the effects of ankle ligament ruptures on ankle joints, fracture instability, and plate stress after distal fibula fracture fixed with a plate created by finite element analysis modeling and loading applied to ligament rupture models that may accompany this fracture.
Methods: A finite element model consisting of three-dimensional fibula, tibia, foot bones, and ankle ligaments was designed to investigate the effects of ligament injuries accompanying plate-detected AO type 44B2.1 fractures on fracture detection, fixation material, and ankle joints. Then, the results were evaluated by modeling ligament rupture in six different ways.
Results: In the modeling where the deltoid and talofibular ligaments are broken together, instability is highest in the ankle (2.31 mm) and fracture line (0.15 mm). The rupture of the anterior and posterior tibiofibular ligaments associated with syndesmosis caused less instability in the fracture and ankle than the single-ligament rupture models of both the deltoid and talofibular ligaments.
Conclusions: In the finite element modeling of AO type 44B2.1 fractures detected with plate, the importance and potential effects of often-overlooked ankle ligament injuries are pointed out. Note that when treating ankle injuries, the ankle should be treated as a whole, with both bone and soft tissue. In some cases, the fracture may represent the visible tip of the iceberg.
背景：踝关节腓骨远端骨折很常见，通常伴有韧带损伤。本研究旨在评估踝关节韧带断裂对踝关节、骨折不稳定性和腓骨远端骨折后钢板应力的影响：设计了一个由三维腓骨、胫骨、足骨和踝关节韧带组成的有限元模型，以研究钢板检测到的 AO 44B2.1 型骨折伴有的韧带损伤对骨折检测、固定材料和踝关节的影响。然后，通过模拟六种不同的韧带断裂方式对结果进行评估：结果：在三角韧带和距腓韧带一起断裂的模型中，踝关节（2.31 毫米）和骨折线（0.15 毫米）的不稳定性最高。与三角韧带和距腓韧带的单韧带断裂模型相比，胫腓前韧带和胫腓后韧带的断裂以及联合韧带的断裂对骨折和踝关节造成的不稳定性较小：在用钢板检测 AO 44B2.1 型骨折的有限元模型中，指出了经常被忽视的踝关节韧带损伤的重要性和潜在影响。需要注意的是，在治疗踝关节损伤时，应将踝关节作为一个整体进行治疗，包括骨骼和软组织。在某些情况下，骨折可能只是冰山一角。
期刊介绍：
The Journal of the American Podiatric Medical Association, the official journal of the Association, is the oldest and most frequently cited peer-reviewed journal in the profession of foot and ankle medicine. Founded in 1907 and appearing 6 times per year, it publishes research studies, case reports, literature reviews, special communications, clinical correspondence, letters to the editor, book reviews, and various other types of submissions. The Journal is included in major indexing and abstracting services for biomedical literature.
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