Abstract：
BACKGROUND: Today, the relative contribution of each ligamentous structure in the stability of the subtalar joint is still unclear. The purpose of this study is to assess the material properties of the different ligamentous structures of the subtalar joint.
METHODS: Eighteen paired fresh-frozen cadaveric feet were used to obtain bone-ligament-bone complexes of the calcaneofibular ligament (CFL), the cervical ligament (CL) and the anterior capsular ligament-interosseous talocalcaneal ligament complex (ACaL-ITCL). The samples were subjected to uniaxial testing to calculate their respective stiffness and failure load.
RESULTS: The stiffness of ACaL-ITCL complex (mean: 150 ± 51 N/mm, 95% confidence interval (CI): 125.0-176.6 N/mm) was significantly higher than both CFL (mean: 55.8 ± 23.0 N/mm, CI: 43.8-67.7 N/mm) and CL (mean: 63.9 ± 38.0 N/mm, CI: 44.4-83.3 N/mm). The failure load of both the ACaL-ITCL complex (mean:382.5 ± 158 N, CI: 304.1-460.8 N) and the CFL (mean:320.4 ± 122.0 N, CI: 257.5-383.2 N) were significantly higher than that of the CL (mean:163.5 ± 58.0 N, CI: 131.3-195.7 N). The injury pattern demonstrated a partial rupture in all CFL and ACaL-ITCL specimens and in 60% of the CL specimens.
CONCLUSIONS: The CFL, CL and ACaL-ITCL show significant differences in their intrinsic mechanical properties. Both the CFL and CL are more compliant ligaments and seem to be involved in the development of subtalar instability. Based on the material properties, a gracilis tendon graft seems more appropriate than a synthetic ligament to reconstruct a CL or CFL. A partial rupture was the most commonly seen injury pattern in all ligaments. A fibular avulsion of the CFL was only rarely seen. The injury patterns need further investigation as they are important to optimize diagnosis and treatment.
METHODS: Eighteen paired fresh-frozen cadaveric feet were used to obtain bone-ligament-bone complexes of the calcaneofibular ligament (CFL), the cervical ligament (CL) and the anterior capsular ligament-interosseous talocalcaneal ligament complex (ACaL-ITCL). The samples were subjected to uniaxial testing to calculate their respective stiffness and failure load.
RESULTS: The stiffness of ACaL-ITCL complex (mean: 150 ± 51 N/mm, 95% confidence interval (CI): 125.0-176.6 N/mm) was significantly higher than both CFL (mean: 55.8 ± 23.0 N/mm, CI: 43.8-67.7 N/mm) and CL (mean: 63.9 ± 38.0 N/mm, CI: 44.4-83.3 N/mm). The failure load of both the ACaL-ITCL complex (mean:382.5 ± 158 N, CI: 304.1-460.8 N) and the CFL (mean:320.4 ± 122.0 N, CI: 257.5-383.2 N) were significantly higher than that of the CL (mean:163.5 ± 58.0 N, CI: 131.3-195.7 N). The injury pattern demonstrated a partial rupture in all CFL and ACaL-ITCL specimens and in 60% of the CL specimens.
CONCLUSIONS: The CFL, CL and ACaL-ITCL show significant differences in their intrinsic mechanical properties. Both the CFL and CL are more compliant ligaments and seem to be involved in the development of subtalar instability. Based on the material properties, a gracilis tendon graft seems more appropriate than a synthetic ligament to reconstruct a CL or CFL. A partial rupture was the most commonly seen injury pattern in all ligaments. A fibular avulsion of the CFL was only rarely seen. The injury patterns need further investigation as they are important to optimize diagnosis and treatment.
摘要：
背景：今天，每个韧带结构在距下关节稳定性中的相对贡献尚不清楚。这项研究的目的是评估距下关节的不同韧带结构的材料特性。
方法：用18只成对的新鲜冷冻尸体足获得跟腓骨韧带（CFL）的骨-韧带-骨复合物，颈韧带（CL）和前囊韧带-骨间韧带复合体（ACaL-ITCL）。对样品进行单轴测试以计算它们各自的刚度和破坏载荷。
结果：ACaL-ITCL复合物的刚度（平均值：150±51N/mm，95％置信区间（CI）：125.0-176.6N/mm）显着高于两个CFL（平均值：55.8±23.0N/mm，CI：43.8-67.7N/mm）和CL（平均值：63.9±38.0N/mm，CI:44.4-83.3N/mm)。ACaL-ITCL复合体的破坏载荷(平均值：382.5±158N，CI：304.1-460.8N)和CFL(平均值：320.4±122.0N，CI：257.5-383.2N）显着高于CL（平均值：163.5±58.0N，CI：131.3-195.7N）。损伤模式显示所有CFL和ACaL-ITCL标本以及60％的CL标本均部分破裂。
结论：CFL，CL和ACaL-ITCL在其固有力学性能方面表现出显著差异。CFL和CL都是更顺从的韧带，似乎参与了距下不稳定性的发展。根据材料属性，股薄肌腱移植物似乎比合成韧带更适合重建CL或CFL。部分断裂是所有韧带中最常见的损伤模式。CFL的腓骨撕脱很少见。损伤模式需要进一步调查，因为它们对于优化诊断和治疗很重要。
方法：用18只成对的新鲜冷冻尸体足获得跟腓骨韧带（CFL）的骨-韧带-骨复合物，颈韧带（CL）和前囊韧带-骨间韧带复合体（ACaL-ITCL）。对样品进行单轴测试以计算它们各自的刚度和破坏载荷。
结果：ACaL-ITCL复合物的刚度（平均值：150±51N/mm，95％置信区间（CI）：125.0-176.6N/mm）显着高于两个CFL（平均值：55.8±23.0N/mm，CI：43.8-67.7N/mm）和CL（平均值：63.9±38.0N/mm，CI:44.4-83.3N/mm)。ACaL-ITCL复合体的破坏载荷(平均值：382.5±158N，CI：304.1-460.8N)和CFL(平均值：320.4±122.0N，CI：257.5-383.2N）显着高于CL（平均值：163.5±58.0N，CI：131.3-195.7N）。损伤模式显示所有CFL和ACaL-ITCL标本以及60％的CL标本均部分破裂。
结论：CFL，CL和ACaL-ITCL在其固有力学性能方面表现出显著差异。CFL和CL都是更顺从的韧带，似乎参与了距下不稳定性的发展。根据材料属性，股薄肌腱移植物似乎比合成韧带更适合重建CL或CFL。部分断裂是所有韧带中最常见的损伤模式。CFL的腓骨撕脱很少见。损伤模式需要进一步调查，因为它们对于优化诊断和治疗很重要。
