12/19/2023 0 Comments Bimalleolar fx![]() ![]() This subsequently resulted in a medial or lateral ankle dislocation without fracture and damage to the anterior talofibular and calcaneofibular ligaments. This mechanism allows for anterior extrusion of the talus through the mortise and predisposes the ankle to damage and rupture of the anterior talofibular and calcaneofibular ligaments, leading to a posteromedial dislocation which is the most common direction of dislocation in pure ankle dislocation. Cadaveric studies by Fernandes recreated this injury by placing the foot in maximum plantar flexion with stress applied into inversion or eversion. The most common injury pattern occurs when the ankle is maximally plantar-flexed with an axial load and forced inversion of the foot. A pure ligamentous dislocation has been reported to occur in multiple directions and by multiple mechanisms. The mechanism of the ankle dislocation depends on whether it is associated with a fracture or not. Usually, the ligaments are so strong that the bones give way and create a fracture-dislocation. The lateral collateral ligaments (including the anterior and posterior talofibular ligaments and the calcaneofibular ligament) act to resist inversion. The deltoid ligaments support the medial ankle and aid in resisting eversion. The tibiofibular syndesmosis limits motion between the tibia and fibula and is composed of the anterior tibiofibular ligament, posterior tibiofibular ligament, and the interosseous tibiofibular joint. The stability of the joint is maintained through three groups of ligaments: the tibiofibular syndesmosis, the deltoid ligament, and the lateral collateral ligaments. Because of the stress placed on the ankle as one pushes off in different directions, it is possible to dislocate it by exceeding the ligamentous strength that encloses the ankle. The human ankle maintains this range of motion under extremely heavy loads and can support several times the human body weight for short periods. The combination of these joints gives the foot the ability to compensate for the loads placed during walking and other activities. Because they share a common axis of motion, the transverse tarsal joint and the subtalar joint are considered part of the same functional unit with the motions of inversion and eversion. The transverse tarsal joint (Chopart’s joint) is the junction between the talus and navicular bone. Below the ankle, at the subtalar joint (joint between the talus and calcaneus), the foot can typically invert 23° and evert about 12° in the frontal plane. It is a ring-like structure with the ability to plantarflex and dorsiflex 40° and 20° respectively in the sagittal plane. The true ankle joint is the tibiotalar joint (between the tibia, fibula and the talus). The ankle joint complex is composed of three main articulations: talocalcaneal (subtalar), transverse-tarsal (talocalaneonavicular) and the tibiotalar (talocrural) joints. 1985 (199):28-38.A fracture-dislocation, occurring in the vast majority A Follow-Up Study of 306/321 Consecutive Cases. ![]() Operative Treatment of Ankle Fracture-Dislocations. Fracture and Dislocation Classification Compendium-2018. Meinberg E, Agel J, Roberts C, Karam M, Kellam J. Die Verletzungen Des Oberen Sprunggelenkes. Combined Experimental-Surgical and Experimental-Roentgenologic Investigations. Some Few General Remarks on Fractures and Dislocations. Adult Ankle Fractures-An Increasing Problem? Acta Orthop Scand. Epidemiology of Adult Fractures: A Review. ![]()
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