Assessment of ankle and hindfoot stability and joint pressures using a human cadaveric model of a large lateral talar process excision: a biomechanical study. Academic Article uri icon

Overview

abstract

  • Lateral talar process fragment excision may be followed by hindfoot instability and altered biomechanics. There is controversy regarding the ideal fragment size for internal fixation versus excision and a concern that excision of a large fragment may lead to significant instability. The aim of this study was to assess the effect of a simulated large lateral talar process excision on ankle and subtalar joint stability.A custom-made seesaw rig was designed to apply inversion/eversion stress loading on 7 fresh-frozen human cadaveric lower legs and investigate them in pre-excision, 5 cm and 10 cm lateral talar process fragment excision states. Anteroposterior radiographs were taken to assess ankle and subtalar joint tilt and calculate angular change from neutral hindfoot alignment to 10-kg forced inversion/eversion. Ankle joint pressures and contact areas were measured under 30-kg axial load in neutral hindfoot alignment.In comparison to the pre-excision state, no significantly different mediolateral angular change was observed in the subtalar joint after 5 and 10 cm lateral talar process fragment excision in inversion and eversion. With respect to the ankle joint, 10-cm fragment excision produced significantly bigger inversion tibiotalar tilt compared with the pre-excision state, Pā€Š=ā€Š.04. No significant change of the ankle joint pressure and contact area was detected after 5 and 10-cm excision in comparison with the pre-excison state.An excision of up to 10 cm of the lateral talar process does not cause a significant instability at the level of the subtalar joint but might be a destabilizing factor at the ankle joint under inversion stress. The latter could be related to extensive soft tissue dissection required for resection.

authors

  • Sands, Andrew
  • White, Charles
  • Blankstein, Michael
  • Zderic, Ivan
  • Wahl, Dieter
  • Ernst, Manuela
  • Windolf, Markus
  • Hagen, Jennifer E
  • Richards, R Geoff
  • Stoffel, Karl
  • Gueorguiev, Boyko

publication date

  • March 1, 2015

Research

keywords

  • Ankle Joint
  • Talus

Identity

PubMed Central ID

  • PMC4602496

Scopus Document Identifier

  • 84929470347

Digital Object Identifier (DOI)

  • 10.1097/MD.0000000000000606

PubMed ID

  • 25789950

Additional Document Info

volume

  • 94

issue

  • 11