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Ligament strain and ankle joint opening during ankle distraction
Summary
Ankle distraction effectively opens the joint for visualization. However, forces under 135 N in the neutral position are safest to avoid ligament strain and bony damage during ankle distraction procedures.
Area of Science:
- Orthopedic surgery
- Biomechanics
- Anatomy
Background:
- Ankle arthroscopy requires joint distraction for optimal visualization.
- The efficacy and potential complications of ankle distraction techniques are not fully understood.
Purpose of the Study:
- To evaluate the effectiveness of ankle distraction in creating joint space.
- To identify potential complications associated with ankle distraction, including ligament strain and bony damage.
Main Methods:
- Six fresh human cadaver ankles were utilized.
- Strain gauges were applied to four key ankle ligaments: deltoid, calcaneofibular, tibiofibular, and anterior talofibular.
- An Acufex ankle distractor applied forces (45-180 N) at varying foot positions (20° dorsiflexion, neutral, 10° plantar flexion).
Main Results:
- Ankle distraction successfully increased the tibiotalar joint opening, aiding visualization.
- Complications such as pin bending, excessive ligament strain, and bony destruction were observed.
- The neutral foot position with forces less than 135 N demonstrated the lowest risk.
Conclusions:
- Ankle distraction is effective for joint visualization but carries risks.
- Safe ankle distraction involves using forces < 135 N in a neutral foot position.
- Careful application is necessary to prevent iatrogenic injury during ankle arthroscopy.