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KMID : 0350519930460020559
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Journal of Catholic Medical College
1993 Volume.46 No. 2 p.559 ~ p.571
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Biomechanical Effects of the Fibula in Load-bearing Ankle Joint
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Abstract
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The ankle is a constantly mobile joint according to the position of the body and walking cycle, and the contact area and pressure are changed in various condition and position of the ankle. The studies of the contact area and pressure in the
joint
have
been performed extensively on the hip and knee, but few on the ankle. No standardized data on the contact area and pressure of the normal and partial fibulectomized ankle joint are available.
This study was performed to clarify the role of fibula in load-bearing ankle. Using eight amputated human legs, the tibiotalar contact area and talofibular pressure were measured in differently designed conditions of the ankle joint [condition A
:
normal ankle(control group), condition B : partial fibulectomy, condition C : partial fibulectomy and rupture of distal tibiofibular ligament and condition D : transfixing screw at distal tibiofibular joint on condition C] at physiological range
of
load
(66Kgf) in three different positions. Authors used the pressure sensitive film on 8 amputated lower extremities to determine the contact area and pressure at the ankle. The data were analyzed with compensatory polar planimeter and pressensor film
pressure chart.
@ES The results were as follows :
@EN 1. Tibiotalar contact area was 4.70±0.47㎠ in neutral ankle position, contact area increased with 5.55±0.51㎠in dorsiflexed position and decreased with 4.20±0.56㎠ in plantar flexed position in controlgroup(P<0.01)
2. Contact area decreased in neutral position in condition B(89.7%), condition C(85.8%) and condition D(68.1%) compared with control group(P<0.05)
3. Contact area decreased in dorsiflexed position in condition B(88.1%), condition C(85.6%) and condition D(66.2%) compared with control group(P<0.05).
4. Contact area decreased in plantar flexed position in condition B(94.0%), condition C(84.7%) and condition D(72.5%) compared with control group(P<0.05).
5. Contact pressure between talus and fibula was 16.03±1.36 Kgf/㎠ at control group. The contact pressure decreased in condition B(68.0%) and condition C(45.1%) (p<0.02), but increased in condition D(146.0%) compared with control group(P<0.01).
As a result of above all, the fibula served as a lateral buttress of the ankle also participated in axial loading during load-bearing. The fibular fracture or partial fibulectomy which can be done frequently in clinical circumstances may develop
the
stress concentration on tibiotalar joint due to reduction of contact area in all position of ankle motion, so the partial fibular resection should be reconsidered. As both the fibula and the distal tibiofibular ligament have very important load
transmit
ting function, the transfixing screw atthe distal tibiofibular joint for the treatment of diastasis of the ankle could affect the biomechanics of this joint.
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