BIOMECHANICAL ANALYSIS OF ANKLE STABILITY FOLLOWING DELTOID LIGAMENT REPAIR AND RECONSTRUCTION
Notice bibliographique
Résumé
The deltoid ligament has been shown to contribute to the stability of the ankle mortise, preventing valgus talar tilt, external rotation, and translation. Research to date assessing the appropriateness of deltoid repair as a means to reintroduce medial stability to a fractured ankle remains unclear. Deltoid ligament reconstruction using autograft or allograft has been proposed in cases of chronic deltoid insufficiency. This biomechanical study sought to assess the stability offered by deltoid repair and reconstruction compared to the native deltoid ligament in its intact, and de-functioned states. Twelve (six pairs) fresh frozen cadaveric lower extremities with intact deltoid ligaments were assessed in a custom-made multi-axial testing apparatus. Each specimen was tested in plantarflexion/dorsiflexion (PF/DF), inversion/eversion (IV/EV), and internal/external rotation (IR/ER). Each specimen was analyzed for angular range of motion (ROM), normalized ROM, and stiffness. The specimens were tested with an intact deltoid ligament, and following disruption via sharp dissection. Subsequently, each pair was either randomized to deltoid repair, or reconstruction. A single double-loaded suture anchor was used to repair the deep and superficial deltoid ligaments. The tibialis anterior tendon was used as graft in the reconstruction group. The tendon was inserted through interosseous tunnels created in the distal tibia to the talus and calcaneus, and secured with an endobutton and interference screws thereby reconstructing both superficial and deep deltoid ligaments. For each phase of testing, three cycles were conducted and data from the last cycle was collected. Angular ROM was significantly greater in deficient specimens compared to intact, repair, and reconstruction groups during PF/DF (p=0.0002, 0.0184, and 0.0036 respectively). For IV/EV, deficient specimen ROM was significantly greater than the intact (p=0.0037) and repair (p=0.0029) groups, but not from the reconstruction (p=0.36). During IR/ER, the deficient ankle was only significantly different from the intact state (p=0.014). Normalized ROM was not significantly different between intact, repair, or reconstruction in any of the motions tested. Stiffness in the deficient ankle was significantly lower in DF/PF compared to intact (p=0.00014) and reconstruction (0.0023) groups but not compared to the repair group. In IV/EV, deficient ankles demonstrated stiffness which was significantly less when compared to intact (p-0.0013) and repair (p=0.000016) groups, but not the reconstruction group. The repair group was significantly stiffer in IV/EV compared to the reconstruction (p=0.016) group. No significant difference in stiffness was observed in IR/ER between any of the groups. Deltoid repair and reconstruction utilizing the techniques described in this study were comparable in returning the ankles to intact state normalized ROM, and confer stability specifically in PF/DF, and IV/EV. These results would suggest that deltoid ligament reconstruction may be used as a reliable alternative to repair in chronic deltoid ligament insufficiency, and in instability cases where repair is not possible.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».