caa a22 4500 605457085 CHVBK 20210128100221.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00167-013-2708-4 doi (NATIONALLICENCE)springer-10.1007/s00167-013-2708-4 The role of the medial ligaments in lateral stabilization of the ankle joint: an in vitro study [Elektronische Daten] [Pejman Ziai, Emir Benca, Gobert Skrbensky, Florian Wenzel, Alexander Auffarth, Selma Krpo, Reinhard Windhager, Tomas Buchhorn] Purpose: The deltoid ligament complex is known as medial stabilizer in the ankle against pronation/eversion. Lateral dual-ligament laxity often results in chronic ankle instability with recurring ankle sprain trauma. The goal of this study is to examine the lateral stabilizing role of the deltoid ligament complex against supination/inversion in case of existing lateral ligament instability. Methods: A torsion simulation was performed on 12 fresh human lower leg cadaver specimens in a loading frame and a specially designed mounting platform. The preset torsion between tibia and calcaneus was primarily set at 30° of internal rotation on specimen in plantar flexion and hind foot inversion. The measured variable was the resisting torque recorded around mechanical tibial axis, which ensures stability in ankle sprain trauma. The first series of measurements were performed on healthy specimens and the following after transecting structures in following order: anterior talofibular ligament (ATFL) in combination with calcaneofibular ligament (CFL), followed by anterior tibiotalar ligament and posterior tibiotalar ligament and finally tibiocalcaneal ligament (TCL). Results: The combined lateral ATFL and CFL instability showed a decrease in the resisting torque, which ensures stability in ankle sprain trauma. Only a transection of TCL (superficial layer of deltoid ligament complex) with existing lateral dual-ligament instability results in a significant decrease in torque (p<0.0001). Conclusion: The goal of the study was to provide the orthopaedic and/or trauma surgeon with quantitative data that may be referred to the substantial stabilizing effect of TCL against supination/inversion in the ankle joint in case of repetitive sprain trauma at a present lateral ligament lesion. Diagnostics of and treatment for lateral ligament instability need to consider the deltoid ligament complex, especially TCL in clinical routine. Springer-Verlag Berlin Heidelberg, 2013 Deltoid ligament complex nationallicence Medial ligaments nationallicence Medial instability nationallicence Ankle joint nationallicence Ankle sprain trauma nationallicence Passive stability nationallicence Ziai Pejman Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria aut Benca Emir Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria aut Skrbensky Gobert Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria aut Wenzel Florian Student School of Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria aut Auffarth Alexander Department of Traumatology and Sports Injuries of the Paracelsus Medical University, Muellber Hauptstraße 48, 5020, Salzburg, Austria aut Krpo Selma Department of Orthopaedic Surgery and Traumatology, Clinical Center University of Sarajevo, Bolnička 25, 71000, Sarajevo, Bosnia and Herzegovina aut Windhager Reinhard Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria aut Buchhorn Tomas Sporthopaedicum Straubing, Bahnhofsplatz 27, 94315, Straubing, Germany aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 1900-1906 0942-2056 23:7<1900 2015 23 167 https://doi.org/10.1007/s00167-013-2708-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-013-2708-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ziai Pejman Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria aut NATIONALLICENCE 700 1- Benca Emir Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria aut NATIONALLICENCE 700 1- Skrbensky Gobert Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria aut NATIONALLICENCE 700 1- Wenzel Florian Student School of Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria aut NATIONALLICENCE 700 1- Auffarth Alexander Department of Traumatology and Sports Injuries of the Paracelsus Medical University, Muellber Hauptstraße 48, 5020, Salzburg, Austria aut NATIONALLICENCE 700 1- Krpo Selma Department of Orthopaedic Surgery and Traumatology, Clinical Center University of Sarajevo, Bolnička 25, 71000, Sarajevo, Bosnia and Herzegovina aut NATIONALLICENCE 700 1- Windhager Reinhard Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria aut NATIONALLICENCE 700 1- Buchhorn Tomas Sporthopaedicum Straubing, Bahnhofsplatz 27, 94315, Straubing, Germany aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 1900-1906 0942-2056 23:7<1900 2015 23 167