Academic literature on the topic 'Lateral Ligament Complex'
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Journal articles on the topic "Lateral Ligament Complex"
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Urvija, Shah, Kothari Arpit, and Gandhi Viplav. "Spectrum of MRI Findings in Ankle Ligament Injuries." International Journal of Pharmaceutical and Clinical Research 16, no. 9 (2024): 643–52. https://doi.org/10.5281/zenodo.13906858.
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<strong>Background:</strong> Ankle trauma is commonly encountered and is most often a sprain injury affecting the ligaments. Accurate diagnosis and appropriate treatment rest on knowledge of complex ligamentous anatomy of ankle and the entire spectrum of pathologies. Magnetic resonance imaging (MRI) is the imaging modality of choice for diagnosing ligament pathologies because of its multiplanar capability and high soft tissue contrast. In this article emphasis is given to the intricate and unique anatomy and orientation of ankle ligaments. Tears of ankle ligaments have been elaborated. <strong>Materials and Methods:</strong> In a retrospective observational study, patient’s data was collected from tertiary care unit from period of January 2024 to June 2024. Ankle MRI was performed using standard protocol on 100 cases. <strong>Results:</strong> In this study, 50 percent cases had injury to lateral ligament complex of which 35 percent were anterior talofibular ligament, 5 percent were posterior talofibular ligament and 10 percent were calcaneofibular ligament. It concluded that lateral ligament complex tears are more common than medial ligament complex. <strong>Conclusion:</strong> MRI visualizes ligamentous anatomy and pathology at the ankle and is being used with increasing frequency in patients following ankle sprains.MR images of ankle ligaments from a sample of patients with ankle pain or injury are presented and reviewed.
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Lee, Jin Woo. "Arthroscopic Lateral Ligament Repair." Orthopaedic Journal of Sports Medicine 7, no. 11_suppl6 (2019): 2325967119S0045. http://dx.doi.org/10.1177/2325967119s00452.
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Ankle sprain is one of the most common sports-related injuries and involves the three ligaments of the lateral ligament complex of the ankle. Approximately 80% of patients tear the anterior talo-fibular ligament (ATFL), while the other 20% of patients tear the ATFL and calcaneo-fibular ligament (CFL). Rarely, the posterior talo-fibular ligament (PTFL) is involved. Non-surgical management of ankle sprains leads to excellent results in most cases for the initial phase. An incidence of 10 – 30% of patients would fail conservative treatment and result in chronic lateral ankle instability (CLAI) that may require surgical intervention. And the CLAI is commonly associated with other lesions, such as osteochondral lesion, soft tissue impingement syndrome, loose body, and peroneal tendon disorder so that diagnostic arthroscopy is mandatory with stabilizing lateral ankle. Although more than 50 surgical procedures have been described for stabilizing the lateral ankle ligaments complex. The original technique of Broström, modified by Gould, has become the gold standard procedure with infrequent exception in the literatures. However, the open technique requires at least a 4-cm-long incision with significant dissection and soft tissue debridement. Recently, there has been a recent advent of published descriptions on arthroscopic procedures for CLAI with advanced anatomic and bio-mechanic researches of lateral ankle ligaments complex. As in other minimal invasive surgical techniques in the foot and ankle, arthroscopic lateral ligament repair has advantages of less pain, addressing intra-articular pathologies, less injury to surrounding tissue, faster recovery, shorter hospital stay, and better cosmetic result. However, there are concerns about this new emerging technique with a technically demanding and lack of long-term clinical results. The purpose of this presentation is to review what has been established for the CLAI and discuss the arthroscopic lateral ligament repair technique.
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Stephens, Michael M., and G. James Sammarco. "The Stabilizing Role of the Lateral Ligament Complex around the Ankle and Subtalar Joints." Foot & Ankle 13, no. 3 (1992): 130–36. http://dx.doi.org/10.1177/107110079201300304.
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The stabilizing role of various ligaments in the lateral side of the ankle and hindfoot was examined experimentally and sequentially using 10 fresh amputated lower limbs. The anterior talofibular ligament contributed to ankle stability in plantarflexion and the calcaneofibular, the fibulotalocalcaneal, and posterior talofibular ligament in all positions. The lateral root of the inferior extensor retinaculum contributed to subtalar stability in neutral and dorsiflexion. The calcaneofibular, fibulotalocalcaneal, and cervical ligaments and the ligament of the anterior capsule of the posterior talocalcaneal joint and the interosseous ligaments contributed to subtalar stability in all positions. The subtalar joint accounted for upward of 50% of ankle/hindfoot inversion after ligament division in the intermalleolar plane.
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Gosselin, Michelle M., Jacob A. Haynes, Jeremy J. McCormick, Jeffery E. Johnson, and Sandra E. Klein. "The Arterial Anatomy of the Lateral Ligament Complex of the Ankle: A Cadaveric Study." American Journal of Sports Medicine 47, no. 1 (2018): 138–43. http://dx.doi.org/10.1177/0363546518808060.
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Background: Ankle sprains are the most common musculoskeletal injury in the United States. Chronic lateral ankle instability can ultimately require operative intervention to decrease pain and restore stability to the ankle joint. There are no anatomic studies investigating the vascular supply to the lateral ankle ligamentous complex. Purpose: To define the vascular anatomy of the lateral ligament complex of the ankle. Study Design: Descriptive laboratory study. Methods: Thirty pairs of cadaveric specimens (60 total legs) were amputated below the knee. India ink, followed by Ward blue latex, was injected into the peroneal, anterior tibial, and posterior tibial arteries to identify the vascular supply of the lateral ligaments of the ankle. Chemical debridement was performed with 8.0% sodium hypochlorite to remove the soft tissues, leaving casts of the vascular anatomy intact. The vascular supply to the lateral ligament complex was then evaluated and recorded. Results: The vascular supply to the lateral ankle ligaments was characterized in 56 specimens: 52 (92.9%) had arterial supply with an origin from the perforating anterior branch of the peroneal artery; 51 (91.1%), from the posterior branch of the peroneal artery; 29 (51.8%), from the lateral tarsal branch of the dorsalis pedis; and 12 (21.4%), from the posterior tibial artery. The anterior branch of the peroneal artery was the dominant vascular supply in 39 specimens (69.6%). Conclusion: There are 4 separate sources of extraosseous blood supply to the lateral ligaments of the ankle. In all specimens, the anterior talofibular ligament was supplied by the anterior branch of the peroneal artery and/or the lateral tarsal artery of the dorsalis pedis, while the posterior talofibular ligament was supplied by the posterior branch of the peroneal artery and/or the posterior tibial artery. The calcaneofibular ligament received variable contributions from the anterior and posterior branches of the peroneal artery, with few specimens receiving a contribution from the lateral tarsal or posterior tibial arteries. Clinical Relevance: Understanding the vascular anatomy of the lateral ligament complex is beneficial when considering surgical management and may provide insight into factors that lead to chronic instability.
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Haraguchi, Naoki, Hidekazu Toga, Nobumasa Shiba, and Fumio Kato. "Avulsion Fracture of the Lateral Ankle Ligament Complex in Severe Inversion Injury." American Journal of Sports Medicine 35, no. 7 (2007): 1144–52. http://dx.doi.org/10.1177/0363546507299531.
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Background Avulsion fracture of the lateral ankle ligaments is often undetected on early radiographs. The epidemiology and treatment of such avulsion fractures have received much less attention than the epidemiology and treatment of rupture of these ligaments. Hypothesis The clinical characteristics of avulsion fracture are different from those of ligament rupture. Unlike nonoperative treatment of lateral ligament rupture, nonoperative treatment of avulsion fracture does not yield satisfactory results. Study Design Cohort study; Level of evidence, 2. Methods A total of 169 consecutive patients with severe inversion injury were classified into a ligament rupture group or avulsion fracture group on the basis of physical examination findings and anterior talofibular ligament and calcaneofibular ligament radiographic views. Age, sex, activity level, and the mechanism of injury were analyzed. Patients in both groups were treated by casting. Follow-up examination of 152 patients included clinical assessment and functional evaluation based on the Karlsson system. Results Avulsion fracture was diagnosed in 44 (26%) of the 169 patients and was most common among children and patients over 40 years of age. Sedentary level activity and low-energy injury were more common in the avulsion fracture group than in the ligament rupture group (77% vs 37%, respectively, P = .001; 68% vs 43%, respectively, P = .004). Nonoperative treatment of avulsion fracture (mean Karlsson score, 89.1 points) yielded satisfactory results that were comparable with those of nonoperative treatment of ligament rupture (mean Karlsson score, 88.4 points) (P = .123). Osseous union was achieved in 65% of the patients with avulsion fracture. Conclusion Avulsion fracture of the lateral ankle ligaments in cases of severe inversion injury is more common than previously believed. Because of the high incidence and difficulty of detection in children, a high level of suspicion is necessary in order to obtain an accurate diagnosis of avulsion fracture in cases of severe inversion injury and to achieve adequate stability.
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Hintermann, Beat, Christian Sommer, and Benno M. Nigg. "Influence of Ligament Transection on Tibial and Calcaneal Rotation with Loading and Dorsi-Plantarflexion." Foot & Ankle International 16, no. 9 (1995): 567–71. http://dx.doi.org/10.1177/107110079501600910.
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The purpose of this study was to quantify the effect of sequential ligament transection (anterior talofibular, calcaneofibular, posterior talofibular, deltoid, and subtalar interosseous ligaments) on the rotational movement of the tibia and the calcaneus as associated with axial loading and dorsi-plantarflexing the foot. Eight cadaver foot-leg specimens were investigated using a unconstrained testing apparatus. As the ankle complex was axially loaded, almost the same internal rotation of the tibia and the same calcaneus eversion was found with and without the various degrees of lateral and medial ligament release; additional sectioning of the subtalar interosseous ligament tremendously increased the resulting tibial and calcaneal rotation. While tibial and calcaneal rotation from foot dorsi-plantarflexing did not alter significantly with transection of the lateral ligaments, almost no tibial and calcaneal rotation occurred after additional sectioning of the deltoid and subtalar interosseous ligament. These results indicate that, after release of the lateral ligaments, the foot becomes partially mechanically disconnected from the tibia by additional transection of the medial ligaments and even further disconnected after transection of the subtalar interosseous ligament.
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De Leeuw, Peter A. J., Jordi Vega, Jon Karlsson, and Miki Dalmau-Pastor. "The posterior fibulotalocalcaneal ligament complex: a forgotten ligament." Knee Surgery, Sports Traumatology, Arthroscopy 29, no. 5 (2021): 1627–34. http://dx.doi.org/10.1007/s00167-020-06431-5.
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Abstract Purpose The purpose of the present anatomical study was to define the exact morphology of the posterior fibulotalocalcaneal ligament complex (PFTCLC), both for a better orientation and understanding of the anatomy, especially during hindfoot endoscopy. Methods Twenty-three fresh frozen specimens were dissected in order to clarify the morphology of the PFTCLC. Results In all specimens, the ligament originated from the posteromedial border of the lateral malleolus between the posterior tibiofibular ligament (superior border) and the calcaneofibular ligament (CFL), (inferior border). This origin functions as the floor for the peroneal tendon sheath. The origin of the PFTCLC can be subdivided into two parts, a superior and inferior part. The superior part forms an aponeurosis with the superior peroneal retinaculum and the lateral septum of the Achilles tendon. From this structure, two independent laminae can be identified. The inferior part of the origin has no role in the aponeurosis and ligamentous fibres run obliquely to insert in the lateral surface of the calcaneus, in the same orientation as the CFL, but slightly more posterior, which was a consistent finding in all examined specimens. The PFTCLC is maximally tensed with ankle dorsiflexion and is located within the fascia of the deep posterior compartment of the leg. Conclusions The PFTCLC is part of the normal anatomy of the hindfoot and therefore should be routinely recognized and partly released to achieve access to the posterior ankle anatomical pathology, relevant for hindfoot endoscopy. The origin of the ligament complex forms the floor for the peroneal tendon sheath. The superior part of the origin plays a role in the formation of an aponeurosis with the superior peroneal retinaculum and the lateral septum of the Achilles tendon.
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Mason, Lyndon, Lara Jayatilaka, Lauren Fisher, Andrew Fisher, Eric Swanton, and Andrew Molloy. "Anatomy of the Lateral Plantar Ligaments of the Transverse Metatarsal Arch." Foot & Ankle Orthopaedics 3, no. 3 (2018): 2473011418S0034. http://dx.doi.org/10.1177/2473011418s00342.
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Category: Midfoot/Forefoot Introduction/Purpose: The anatomy of the Lisfranc complex is well understood. In contrast, the lateral tarsometatarsal ligamentous structures are under-investigated. Our study aimed to identify the plantar ligamentous structures of the lateral tarsometatarsal joints and their significance in transverse metatarsal arch injuries. Methods: We examined 10 cadaveric lower limbs that had been preserved for dissection at the Human Anatomy and Resource Centre at Liverpool University in a solution of formaldehyde. The lower limbs were carefully dissected to identify the ligamentous structures of the plantar aspect of the transverse metatarsal arch. Results: In all specimens, the long plantar ligament blended with a transverse metatarsal ligament spanning from the 2nd to the 5th metatarsal. This transverse metatarsal ligament formed the basis of the roof and distal aspect of the peroneus longus canal. The separate long plantar ligament formed the floor of the peroneus longus canal. In addition, separate intermetarsal ligaments were identifiable connecting each metatarsal. The long plantar ligament provides a connection through the transverse metatarsal ligament, connecting the transverse and longitudinal arches of the foot Conclusion: The plantar ligamentous structures of the lateral tarsometatarsal joints are a combination of individual intermetatarsal ligaments and a transverse metatarsal ligament. This explains the homogenous nature of a divergent tarsometatarsal joint injury and why middle and lateral columns move as one. It also has clinical significance in the observation that in some cases lateral column instability can be overcome when the middle column is stabilised.
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Nag, Kushal, and Ken Jin Tan. "Lateral Ankle Ligament Repair: Evolution of Technique from Open to Arthroscopy." Journal of Foot and Ankle Surgery (Asia Pacific) 1, no. 2 (2014): 65–68. http://dx.doi.org/10.5005/jp-journals-10040-1015.
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ABSTRACT One of the most common injuries of the lower extremity is the lateral ankle sprain. In recent years, with greater emphasis on physical fitness, the chronically painful and unstable lateral ankle is an increasing common clinical finding presenting to the outpatient clinic. If residual instability and pain is still present after a course of physiotherapy, the patient should be presented with surgical options to restore ankle stability. Several surgical techniques have been described for the treatment of chronic ankle instability. Recently, some authors have developed arthroscopic suture anchor techniques to repair the lateral ankle ligaments with excellent results. The authors’ aim is to give an overview of the various techniques for repair or reconstruction of the lateral ligament complex with special emphasis on the arthroscopic lateral ligament reconstruction. How to cite this article Nag K, Tan KJ. Lateral Ankle Ligament Repair: Evolution of Technique from Open to Arthroscopy. J Foot Ankle Surg (Asia-Pacific) 2014;1(2):65-68.
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Haj Hmaidi, Mohamed A., Fedor L. Lazko, Aleksey P. Prizov, et al. "Mid-term results of the treatment of acute postero-lateral rotational instability of the elbow joint." Journal of Clinical Practice 14, no. 2 (2023): 44–53. http://dx.doi.org/10.17816/clinpract225840.
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Background: Dislocations of the forearm are rare injuries with the annual incidence of 6.1 cases per 100 000 population. Postero-lateral rotational instability is the most common complication after the conservative treatment of forearm dislocations. To restore the congruency and provide early movements in the elbow joint, the primary repair or reconstruction of the damaged ligaments of the elbow are required. Aim: to evaluate the clinical and functional results after the surgical repair of the elbow joint ligaments in acute postero-lateral rotational instability. Methods: The study was based on a retrospective analysis of a series of clinical cases, including 17 patients with acute postero-lateral rotational instability, among them 5 simple forearm dislocations, 9 fracture-dislocations of the forearm and 3 fractures of the radial head. Refixation of the lateral ulnar ligament was performed with anchor fixation or bone tunnels. The evaluation was performed using the clinical aspects (the lateral pivot shift test, the range of motion), according to the scale for the evaluation of the elbow joint functional condition (MEPS), Oxford scale of the elbow joint evaluation (OEC), the X-ray results were also estimated. Results: In all the cases the elbow joint stability had been achieved, according to the X-ray and clinical aspects. In 4 cases, additional plasty of the medial collateral ligament was needed and performed after the restoration of the lateral ligament complex. According to the MEPS scale, 58% of the achieved results were excellent, 35% were good and 5.8% were satisfactory. Conclusion: The restoration of the lateral ulnar collateral ligament complex is a safe and effective procedure, which restores the elbow joint stability and allows the patients to return to full physical activity and avoid the development of postero-lateral rotational joint instability.
Dissertations / Theses on the topic "Lateral Ligament Complex"
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Rubin, Marcio Luiz Librelotto. "Eficácia da radiografia de estresse no diagnóstico das lesões ligamentares crônicas do complexo lateral do tornozelo." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/70420.
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Introdução: A entorse do tornozelo com lesão ligamentar é uma patologia muito prevalente nos ambulatórios de traumatologia. Objetivos: Considerando que inúmeros Municípios brasileiros não dispõem de aparelhos de ressonância nuclear magnética e devido ao alto custo desse exame, este trabalho avaliou a Radiografia de Estresse (RE) do tornozelo no diagnóstico das lesões ligamentares crônicas do complexo lateral do tornozelo, confirmados através da ressonância nuclear magnética (RNM). Métodos: Foram empregados os dois métodos de diagnóstico em 31 pacientes, de ambos os sexos, com idade entre 18 e 60 anos, que apresentaram entorse do tornozelo e lesão do complexo lateral do tornozelo retrospectivamente, com mais de 30 dias de evolução e que apresentavam alguma queixa clínica no tornozelo. Resultados: Dos 31 pacientes avaliados, 100% apresentaram lesão do ligamento fíbulo-talar anterior (LFTA) na RNM, e 14 pacientes (45%) apresentaram lesão do ligamento fíbulo-talar anterior e ligamento fíbulo-calcâneo (LFC). Na Radiografia de Estresse, evidenciou-se que 27 pacientes (87%) apresentavam algum grau de lesão ligamentar. Quando se avaliaram os 14 pacientes com lesão no ligamento fíbulo-talar anterior e fíbulo-calcâneo, a RE permitiu um diagnóstico positivo em 13 casos (92,8%). Conclusão: A Radiografia de Estresse é uma metodologia importante e de baixo custo no diagnóstico das lesões crônicas do complexo lateral do tornozelo.<br>Introduction: Ankle sprain with ligament injury is a very prevalent disease in ambulatory trauma. Purposes: Considering that many Brazilian towns do not have the nuclear magnetic resonance imaging (MRI) machines and the high cost of this examination, this study has evaluated the effectiveness of ankle stress radiographies (SR) in the diagnosis of chronic ligament injuries of the lateral ankle complex in patients previously diagnosed by clinical examination and confirmed by MRI. Methods: We have used both methods of diagnosis in 31 patients of both sexes, aged between 18 and 60, who had both an ankle sprain and lateral ankle complex injury retrospectively for more than 30 days and who had some clinical complaints. Results: From the 31 cases evaluated by MRI, 100% showed anterior talofibular ligament (ATFL) injury while 45% (14 patients) showed anterior talofibular ligament (ATFL) injury and calcaneofibular ligament (CFL) injury. On stress radiographies we have noticed that 27 patients (87%) had some degree of ligament injury. When we assessed 14 patients with anterior talofibular ligament (ATFL) injury and calcaneofibular ligament (CFL), the SR has given a positive diagnosis in 13 cases (92.8%). Conclusion: Stress radiography is an important and a low cost methodology in the diagnosis of chronic lesions of the lateral ankle complex.
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Ribeiro, Paulo Gil Azevedo. "Imaging evaluation of the lateral collateral ligament complex of the ankle: The role of magnetic resonance." Master's thesis, 2019. http://hdl.handle.net/10316/89649.
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Dissertação de Mestrado em Medicina do Desporto apresentada à Faculdade de Medicina<br>Introdução: A entorse do tornozelo é uma lesão de apresentação frequente no serviço de urgência e uma das lesões desportivas mais comuns do mundo, sendo o complexo ligamentar lateral um dos mais comummente lesados. A capacidade da Ressonância Magnética (RM) de avaliação da anatomia e das lesões do complexo ligamentar lateral do tornozelo de forma não invasiva encontra-se bem estabelecida. A compreensão das dimensões do complexo ligamentar lateral do tornozelo é essencial para o diagnóstico e melhoria do algoritmo de tratamento destas lesões.Materiais e métodos: As imagens de RM de 29 indivíduos (média de idades: 34,5 anos; 19 homens e 10 mulheres) que não mostravam sinais de lesões prévia do complexo ligamentar lateral do tornozelo foram avaliados retrospetivamente. O comprimento do ATFL e PTFL, a espessura do ATFL, PTFL e CFL e a altura do PTFL foram avaliados.Resultados: O comprimento e espessura médios do ATFL foram 18,08 ± 2,32 mm e 2,08 ± 0,40 mm respetivamente. O comprimento, espessura e altura médios do PTFL foram 21,61 ± 2,57 mm, 5,30 ± 0,89 mm e 6,10 ± 0,94 mm respetivamente. A espessura média do CFL foi 1,90 ± 0,20 mm.Discussão: Os resultados deste estudo estão em concordância com os estudos cadavéricos e de RM disponíveis. A avaliação precisa por RM das dimensões destes ligamentos permite uma melhor compreensão da sua anatomia o que, por sua vez, levará a um melhor diagnóstico, algoritmo de tratamento e planeamento cirúrgico de uma lesão comum na área da traumatologia desportiva.<br>Introduction: Ankle ligamentous sprain is a common presenting concern to the emergency department and one of the most common sport’s injuries in the world and the lateral collateral ligament complex is the one most commonly injured. Magnetic resonance imaging (MRI) has proven that is well capable of noninvasively demonstrating the anatomy as well as injuries of the lateral ligamentous complex. An understanding of the native dimensions of the lateral collateral ligaments is essential to the diagnosis and improvement of the treatment algorithm of these ligament injuries.Materials and Methods: Magnetic resonance images of 29 subjects (mean age 34,5 years; 19 men and 10 female) that showed no previous injury of the lateral collateral ligament of the ankle were retrospectively evaluated. The length of ATFL and PTFL, thickness of ATFL, PTFL and CFL and width of PTFL were evaluated.Results: The mean length and thickness of ATFL was 18,08 ± 2,32 mm and 2,08 ± 0,40mm respectively. The mean length, thickness and width of PTFL was 21,61 ± 2,57 mm, 5,30 ± 0,89 mm and 6,10 ± 0,94 mm respectively. The mean thickness of CFL was 1,90 ± 0,20 mm.Discussion: This study’s results are in accordance with the cadaveric and magnetic resonance imaging studies available. MRI assessment of the accurate dimensions of these ligaments allows a better understanding of its anatomy which will allow a better diagnosis, treatment algorithm and surgical planning of a lesion that is so common in the sports trauma area.
Books on the topic "Lateral Ligament Complex"
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Naqui, Zaf, and David Warwick. Bone and joint injuries of the wrist and forearm. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198757689.003.0004.
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The forearm is a complex quadrilateral structure linked by the proximal and distal radioulnar joints, ligaments, which include the interosseous membrane and triangular cartilage, and several obliquely orientated muscles. A displaced fracture or ligament rupture within this forearm is likely to involve other structures. Treatment requires anatomic recovery of stable function. The ulnar corner can sustain fractures or ligament ruptures which affect stable, pain-free, congruous forearm rotation. The distal radius may fracture after high- or low-energy trauma; anatomic reduction may not be essential in all; inaccuracy may lead to loss of rotation and ulnocarpal abutment but long-term arthritis is unusual. Children’s fractures are managed with consideration of remodeling potential. The scaphoid is vulnerable to non-union; plaster immobilization, early percutaneous fixation, and later bone-grafting all have roles. Salvage for osteoarthritic non-union may reduce pain but compromises function. Rupture of the carpal ligaments may cause substantial disruption and require complex reconstruction.
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Williams, Andy, and Ali Narvani. Combined ligament injuries around the knee. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.008012.
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♦ Any knee with major disruption of two ligaments is likely to have been dislocated at the time of injury♦ Knee dislocations are associated with high risk of neurovascular injury. Angiography or vascular ultrasound is mandatory♦ In knee dislocations, following immediate reduction and stabilization usually with a brace, acute repair of the ruptured soft tissue structure within 2–3 weeks of injury is likely to provide superior results compared to later reconstruction♦ Management of most multiligament injuries is complex and requires surgical intervention therefore specialist centres are best to be involved early♦ In cases with associated malalignment, osteotomy can improve the results of ligament reconstruction.
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Chiravuri, Srinivas. Lateral Femoral Cutaneous Neuropathy—Meralgia Paresthetica. Edited by Meghan E. Lark, Nasa Fujihara, and Kevin C. Chung. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190617127.003.0014.
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Meralgia paresthetica is characterized by anterolateral thigh pain, paresthesia, or dysesthesia without motor weakness. This is due to idiopathic or iatrogenic injury to the lateral femoral cutaneous nerve (LFCN, dorsal rami of L2-L3). Risk factors include obesity, diabetes, and external compression near the inguinal ligament’s attachment to the anterior superior iliac spine. Diagnosis is based on clinical presentation and electrodiagnostic studies. Initial management includes behavioral modification, physical therapy, and pharmacotherapy. More invasive treatment modalities include LFCN infiltration, pulsed radiofrequency, direct nerve stimulation, and spinal cord stimulation. Ultrasound-guided neurectomy is also an effective way to localize the nerve structure and ensure complete nerve transection.
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Colaco, Henry, Fares Haddad, and Cathy Speed. Knee injuries. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199533909.003.0031.
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The knee is a synovial hinge joint which achieves a range of movement of 0°–150° flexion with a complex combination of sliding, gliding, and rolling movements. The three components involved are the medial and lateral compartments of the tibiofemoral joint and the patellofemoral joint. The joint is lined with hyaline articular cartilage and stability is primarily provided by the joint capsule, menisci, ligaments, and muscles....
Book chapters on the topic "Lateral Ligament Complex"
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Tria, Alfred J., and Giles R. Scuderi. "The Lateral Collateral Ligament and the Posterolateral Ligament Complex." In Ligaments of the Knee. Springer Nature Switzerland, 2024. https://doi.org/10.1007/978-3-031-66615-5_4.
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"Lateral Collateral Ligament Complex, Knee." In Diagnostic Imaging: Musculoskeletal Trauma. Elsevier, 2016. http://dx.doi.org/10.1016/b978-0-323-39253-2.50171-3.
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Miller, Mark, and Timothy Sanders. "Lateral Collateral Ligament Complex and Posterolateral Corner Structures." In Presentation, Imaging and Treatment of Common Musculoskeletal Conditions Expert Consult. Elsevier, 2012. http://dx.doi.org/10.1016/b978-1-4377-0914-8.00082-5.
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Lucarelli, Mark J. "Management of Blepharoptosis." In Surgery of the Eyelid, Lacrimal System, and Orbit. Oxford University Press, 2011. http://dx.doi.org/10.1093/oso/9780195340211.003.0014.
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A thorough understanding of upper eyelid anatomy is essential for the ptosis surgeon. The upper eyelid consists of skin, orbicularis, septum, tarsus, levator, Muller’s muscle, and conjunctiva. The skin and orbicularis form the anterior lamella. Conceptually, the orbicularis may be subdivided according to its topography into pretarsal, preseptal, and orbital components (over the orbital rim and extending to the frontalis muscle superiorly). The orbital septum is a fibrous lamellar structure arising from the periosteum over the superior and inferior orbital rims. In the upper eyelid, the orbital septum fuses with the levator aponeurosis approximately 2 to 5 mm above the superior tarsal border in Caucasians. In Asian patients, the septum extends further inferiorly into the eyelid. Preaponeurotic orbital fat is normally located behind the orbital septum in the preaponeurotic space. The preaponeurotic fat is an important landmark for surgeons as it lies immediately anterior to the levator aponeurosis. The tarsus of the upper eyelid is a firm, dense connective-tissue plate that provides rigidity to the eyelid. The upper tarsal plate measures approximately 10 mm vertically in the center of the eyelid. The tarsal plate is usually 1 mm thick. The levator complex originates from the periorbita of the lesser wing of the sphenoid at the annulus of Zinn. The muscular portion of the levator in adults is approximately 36 mm long, while the aponeurosis is 14 to 20 mm long. The bony attachments of the aponeurosis are via its horizontal expansions, the medial and lateral horns. The lateral horn, which is much stronger than the medial horn, passes through the lacrimal gland and divides it into the palpebral and orbital lobes. The lateral horn attaches to the periorbita of the orbital tubercle and to the lateral canthal tendon. The medial horn is a thin, delicate structure. It attaches loosely with the posterior portion of the medial canthal tendon and curves medially and posteriorly to insert at the posterior lacrimal crest and the adjacent periorbita of the medial orbital wall. Whitnall’s superior transverse ligament (Whitnall’s ligament) is a condensation of the fascial sheaths of the levator muscle located superior to the area of transition of the levator muscle to the levator aponeurosis (musculoaponeurotic junction).
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Wong, Agnes. "Nuclear and Infranuclear Ocular Motor Disorders." In Eye Movement Disorders. Oxford University Press, 2008. http://dx.doi.org/10.1093/oso/9780195324266.003.0021.
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Binocular diplopia is usually caused by strabismus, whereas monocular diplopia is usually caused by ocular diseases. Incomitant diplopia is usually caused by an acquired strabismus resulting from abnormal innervation or mechanical restriction. The oculomotor (third) nerve: ■ Innervates the medial rectus, superior rectus, inferior rectus, inferior oblique, and levator palpebrae muscles ■ Carries parasympathetic fibers to the iris sphincter and the ciliary body. ■ Common causes of third nerve palsy: Adults: aneurysms, vascular disease (including ischemia, diabetes, hypertension, and inflammatory arteritis), trauma, migraine Children: birth trauma, accidental trauma, neonatal hypoxia, migraine The third nerve originates from the oculomotor nucleus complex, which lies at the ventral border of the periaqueductal gray matter in the midbrain. The nerve fascicle passes ventrally through the medial longitudinal fasciculus, the tegmentum, the red nucleus, and the substantia nigra, and finally emerges from the cerebral peduncle to form the oculomotor nerve trunk, which lies between the superior cerebellar and posterior cerebral arteries. The nerve then passes through the subarachnoid space, running beneath the free edge of the tentorium. It continues lateral to the posterior communicating artery and below the temporal lobe uncus, where it runs over the petroclinoid ligament. It pierces the dura mater at the top of the clivus to enter the cavernous sinus. Within the cavernous sinus, the nerve runs along the lateral wall of the sinus together with the trochlear nerve and the ophthalmic (V1) and maxillary (V2) divisions of the trigeminal nerve. As it leaves the cavernous sinus, it divides into the superior and inferior divisions, which pass through the superior orbital fissure, and enters the orbit within the annulus of Zinn. Within the orbit, the smaller superior division runs lateral to the optic nerve and ophthalmic artery and supplies the superior rectus and levator palpebrae muscles. The larger inferior division supplies the medial rectus, inferior rectus, and inferior oblique muscles, as well as the iris sphincter and ciliary body.
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Aygun, Umit, and Orkun Halac. "Medial Collateral Ligament Rupture Diagnosis, Treatment, and Rehabilitation Process." In Ligament Reconstruction and Rehabilitation [Working Title]. IntechOpen, 2024. http://dx.doi.org/10.5772/intechopen.1006295.
Full textAbstract:
Medial collateral ligament (MCL) injury is the most commonly encountered ligament injury following knee trauma. The MCL and posterior oblique ligament (POL) are the primary stabilizers against valgus stress in the knee. Most isolated MCL injuries are treated with a brace and early mobilization. However, in cases where complex injuries accompany the MCL injury, such as femoral avulsion fractures, open injuries, MCL injury with meniscus tear and joint dislocation, and distal MCL ruptures involving the pes anserinus tendon insertion area, surgical treatment is necessary. Additionally, cases involving posterior cruciate ligament (PCL) tears and combined anterior and posterior cruciate ligament (ACL and PCL) tears require surgical intervention. In cases where MCL injury occurs alongside anterior cruciate ligament (ACL) injury, conservative treatment is initially recommended, with potential ACL repair in the later stages. Recurrent medial instability after conservative treatment can lead to secondary ACL injury, muscle weakness, and osteoarthritis.
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Duance, Victor, and Sally Roberts. "The intervertebral disc—structure, composition, and pathology." In Oxford Medical Publications Soft Tissue Rheumatology. Oxford University PressNew York, NY, 2004. http://dx.doi.org/10.1093/oso/9780192630933.003.0004.
Full textAbstract:
Abstract The spine is a complex structure comprised of vertebrae, muscles and ligaments that combine to provide both strength and flexibility. To enable extension, flexion, lateral bending, and rotation each vertebral body is interposed with a soft deformable tissue, the intervertebral disc.(1) There are 24 intervertebral discs in the human spine, 7 in the cervical, 12 in the thoracic, and 5 in the lumbar regions (Fig. 1). The overall function of the intervertebral discs is to absorb and dissipate the high compressive and torsional forces experienced by the spine without compromising its flexibility.
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Gutsalenko, Yuriy, and Tetyana Tretyak. "FORMATION OF WORKING SURFACES AND RESEARCH OF QUALITATIVE INDICATORS OF NON-EVOLVENT GEARS (REVIEW AND PROSPECTS OF DEVELOPMENT)." In Integration of traditional and innovation processes of development of modern science. Publishing House “Baltija Publishing”, 2020. http://dx.doi.org/10.30525/978-9934-26-021-6-35.
Full textAbstract:
From the standpoint of the development of possibilities of application in theory and practice, the works of Prof. B. A. Perepelitsa from Kharkov Polytechnic Institute and his disciples to develop an applied methodology of multiparameter mappings in relation to the profiling and functioning of complex curvilinear objects and transmission mechanisms in mechanical engineering, mainly with examples of gears, are presented. The work substantiates the relevance of the study of gears with a complex non-involute profile of the side surfaces of the teeth, which in some applications have advantages over involute gears and are devoid of some of their drawbacks associated with quality indicators. A technique for obtaining mating surfaces of the teeth of non-invasive gears as envelopes of the specified surfaces of the teeth of tools is described. A scheme for forming pairs of non-involute gears, from which a gearing can be composed, is proposed. At the same time, diamond-abrasive tools are considered as shaping the working gear profile in its cutting according to the copying scheme and finishing according to the rolling honing scheme. In the first case, the profile of a special shaped tool on a high-strength metal bond is supported by a master electrode according to the scheme of the anodic connection of the tool into the electric circuit of dressing, similar to diamond spark grinding. In the second case, the use of gear wheels-hones on elastic ligaments is shown. It is shown that to obtain the mating surfaces of the teeth of two non-involute gears, two tool rails can be used with the profiles of the side surfaces of the teeth opposite to each other. As a nonlinear profile of the tooth lateral surface of the tool rail, some part of one of the simulated flat kinematic curves is considered. A description of the program developed in accordance with the described method is given, which allows you to calculate the geometric characteristics of the shaped profiles of the gear pair wheels, visualize the shaping process, and also determine the quality indicators of the gearing. Thus, the prerequisites were created for choosing from the resulting geometric modeling of the curve field of such tooth profiles of the tools, which would provide the most rational combination of the tooth profiles of the gears processed by them and the required quality parameters of the gear teeth. The results of the study of the pressure ratio between the teeth of a gear and the overlap ratio of gears when choosing the shape of the tooth profiles are presented. A series of numerical experiments for gearing, formed by pairs of tool rails with different profiles of the side surfaces of the teeth straight, convex and concave, as well as convex-concave were performed. It is shown that non-involute gearing can have large reduced radii of curvature (and consequently smaller pressure coefficients) at the points of tangency of the profiles compared to involute gearing with a slight increase or decrease in the gearing overlap ratio. The most preferable is the variant of the rails with convex and concave tooth profiles, which provides the best values of both quality indicators of the engagement.
Conference papers on the topic "Lateral Ligament Complex"
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Button, Keith D., Mark A. Davison, Jerrod E. Braman, Maureen C. Schaefer, and Roger C. Haut. "Effect of Shoe Stiffness on Injury Produced Under External Rotation of the Foot in Human Cadavers." In ASME 2013 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/sbc2013-14719.
Full textAbstract:
Ankle sprain is a common occurrence in sports, accounting for 10–30% of injuries 9. Injury to the lateral ligamentous complex occurs under excessive foot inversion and is known as a “lateral ankle sprain” 1. Injury to the anterior deltoid ligament (ADL), which consists of the tibionavicular ligament (TiNL) and the anterior tibiotalar ligament (ATiTL), is known as a “medial ankle sprain” 13. High ankle sprains occur in the distal tibiofibular syndesmosis, which is comprised of the anterior and posterior tibiofibular ligaments (ATiFL and PTiFL) and the interosseous ligament (IOL) 2. While approximately 85% of ankle sprains are lateral ankle injuries, syndesmotic (high) and medial injuries typically result in more time off the field. The mechanism of both high and medial ankle sprain is commonly ascribed to excessive internal rotation of the upper body, while the foot is planted on the playing surface.
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Lee, Jordan, and Frank Fronczak. "Knee Joint Response to Compressive Loading and Ligament Injury." In ASME 1999 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 1999. http://dx.doi.org/10.1115/imece1999-0446.
Full textAbstract:
Abstract The knee joint is a six degree-of-freedom joint which has a complex response to loading. The joint has a characteristic behavior for particular ligament injuries such as anterior cruciate ligament failure. The response of the joint to a combination of compressive loading and secondary loadings was examined in this study. The secondary loadings were: an anterior force, a valgus moment, an internal torque, or an external torque. A goat model was used with 17 specimens testing different ligament injuries in vitro, specifically stretched or severed anterior cruciate ligaments (ACL) and lateral collateral ligaments (LCL). The femur was held fixed and the tibia loaded in a specially designed apparatus, allowing complete six degree-of-freedom joint motion. The motion of the tibia with respect to the femur was recorded using a coordinate measuring machine. The knee joint demonstrated sensitivity to ACL injuries but not to LCL injuries for the loadings examined. The response to ACL injuries was more highly dependant on the compressive load than the secondary loadings for all tests.
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Al Kork, Samer Khodor, Farid Amirouche, Edward Abraham, and Mark Gonzalez. "Development of 3D Finite Element Model of Human Elbow to Study Elbow Dislocation and Instability." In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206282.
Full textAbstract:
The mechanics of elbow dislocation and its stages of dislocation are complex and not well understood. Reconstructing a fall where someone lands on their hand is one of the most challenging problem in biomechanics. Current models which attempt to reconstruct falls usually focus on experimental kinematical conditions that cause the fall coupled with inverse dynamics to determine the joint and muscles forces [1,2] to provide on insight into the joint instability. Our hypothesis based on our experimental investigation is that the mechanism of posterior elbow dislocation is initiated at radial head where the ulna and coronoid fracture followed by anterior tearing of the joint capsule, lateral collateral ligament will then rupture followed by posterior medial collateral ligament rupture and then the medial collateral ligament peeling off the ulna. In this study we developed a quasi-static three-dimensional finite element of human elbow joint, and conducted several cadaveric studies to study elbow dislocation. The FE model is used to investigate how the ligaments, cartilages behave under different flexion, extension of the elbow. Dislocation is investigated as function of different loads and moments applied to the radius-ulna with arm being flexed and configured into a supination or pronation.
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Vogrin, Tracy M., Savio L. Y. Woo, Jürgen Höher, Marsie A. Janaushek, C. Benjamin Ma, and Christopher D. Harner. "Biomechanical Evaluation of a Posterior Cruciate Ligament Reconstruction in the Knee Using Robotic Technology." In ASME 1998 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 1998. http://dx.doi.org/10.1115/imece1998-0011.
Full textAbstract:
Abstract Clinical outcomes of reconstructive surgery for injuries to the posterior cruciate ligament (PCL) of the knee have been unsatisfactory, with persistent instability predisposing patients to early degenerative joint disease [Clancy, 1983]. One explanation for these outcomes has been the high incidence (up to 60%) of associated injuries to the posterolateral structures (PLS), which include the lateral collateral ligament (LCL) and popliteus complex. Combined PCL/PLS injuries are particularly debilitating because restraints to both posterior tibial translation and external rotation are lost [Grood, 1988]. Further, PLS injuries are difficult to reconstruct due to its complex anatomy; thus, often only the PCL is reconstructed when combined injuries occur.
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Yoganadan, Narayan, John Humm, Jamie Baisden, Vicky Varghese, and Anjishnu Banerjee. "Human Tolerance to Injury Under Complex Head-Neck Loading." In ASME 2022 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2022. http://dx.doi.org/10.1115/imece2022-95731.
Full textAbstract:
Abstract Advancements in automated vehicles may position the occupant in postures different from the current, standard posture. It may affect human tolerance responses. The objective of this study was to determine the lateral bending tolerance of the head-cervical spine with initial head rotation posture using loads at the occipital condyles and lower neck and describe injuries. Using a custom loading device, head-cervical spine complexes from human cadavers were prepared with load cells at the ends. Lateral bending loads were applied to the pre-rotated specimens at 1.5 m/s. At the occipital condyles, peak axial and antero-posterior and medial-lateral shear forces were: 316–954 N, 176–254 N, and 327–508 N, and coronal, sagittal, and axial moments were:27.1–37.8 Nm, 20.9–38.4 Nm, and 9.7–19.8 Nm. At the lower neck, peak axial and shear forces were: 677–1004 N, 115–227 N, and 178–350 N, and coronal, sagittal, and axial moments were: 30–39.5 Nm, 7.6–21.3 Nm, and 5.7–13.4 Nm. Ipsilateral atlas lateral mass fractures occurred in four out of five specimens with varying joint diastasis and capsular ligament involvements. Acknowledging that the study used a small sample size, initial tolerances at the occipital condyles and lower neck were estimated using survival analysis. Injury patterns with posture variations are discussed.
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Dey, Roopam, Sarthak Patnaik, and Sudesh Sivarasu. "Novel Device to Accurately Locate Femoral Insertion Landmark in Medial Patellofemoral Ligament (MPFL) Reconstruction." In 2017 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/dmd2017-3500.
Full textAbstract:
Medial Patello Femoral Ligament (MPFL) is the main stabilizer of the patellar bone in the knee complex. This fan shaped ligament prevents lateral dislocations of patella, especially during the initial 30° of knee flexion as there is minimal bony support from femur on the lateral aspect of the patella [1–2]. Patella dislocations are one of the common knee joint pathologies and it has been reported that each dislocation of the patella induces micro-tears in the MPFL [3]. It has been also observed in previous studies that there exists a very high chance of patellar re-dislocations for those individuals who have experienced the dislocation once. Complete MPFL rupture occurs in 94% of the patients suffering from repeated patellar dislocations [3–4]. Out of the 130 various methods of MPFL reconstruction, the Double Bundle Procedure is the most commonly used as it provides a larger degree of pain-free range of motion [5–8]. Locating the exact drilling location on the medial aspect of the patella and the medial femur is a challenge for the surgeon and literature suggests that the current procedure leads to non-anatomical placement of the ligament [9]. A novel device has been developed (Pat-Rig) to address the issue of locating the exact drill locations of the ligament graft tunnels into the patella [10–12]. This paper addresses the second problem of locating the femoral landmark accurately.
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Wan, Chao, Zhixiu Hao, and Shizhu Wen. "The Joint Biomechanics Change by Different Anterior Cruciate Ligament Constitutive Models Under Axial Torque Load." In ASME 2012 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/imece2012-85758.
Full textAbstract:
According to the previous papers, it was demonstrated that anterior cruciate ligament (ACL) played an important role in resisting the coupled anterior-posterior laxity rather than the rotation laxity under axial torque load of knee joint. In the biomechanics simulation research of knee joint, some different ligament constitutive models were presented to describe the ACL material behavior. However, there is few published paper to study the effect of variable ligament constitutive model on the joint biomechanics under axial torque load. In this paper, a 3-dimension finite element model of an intact tibiofemoral joint including all the main anatomical structures was reconstructed and two ACL constitutive models were compared under 10 Nm femur external torque load. The two ACL constitutive models corresponded to an isotropic hyperelastic model and a transversely isotropic hyperelastic model considering fiber effect, respectively. All the ACL material properties of the two constitutive models were defined by fitting the same stress-strain data. Another model with ACL resected was also analyzed under the same load to estimate the function ACL played under joint axial torque load. It was found that the resection of ACL changed the knee joint deformations significantly in all directions except the distal-proximal translation. In the ACL resected joint model, the internal-external rotation, anterior-posterior and medial-lateral translations increased by about 20%, 500% and 600%, respectively. Comparing to the ACL intact joint model, the Mises stress values of medial collateral ligament decreased while that on lateral collateral ligament increased greatly (from 35 MPa to 61 MPa). In the comparison of the two different ACL constitutive models, the internal-external rotation, as the highest deformation of the knee joint, changed by about 11% and the maximal deformation alteration was obtained in the anterior-posterior translation (about 80%). Both the highest stress value and distribution on ACL have altered mostly while the Mises stress distributions of other ligaments and menisci have changed slightly. The alteration of joint kinematics and ligament biomechanics by different ACL constitutive models would be due to the different descriptions of the material transverse behavior and the real complex ACL stress distribution under an axial torque load, although the longitudinal material behaviors described by different ACL constitutive models were almost the same based on the same experiment data.
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Killian, Megan L., Dan Isaac, Roger C. Haut, Loic M. Dejardin, Darin Leetun, and T. L. Haut Donahue. "Traumatic Anterior Cruciate Ligament Tear and Its Implications on Meniscal Degradation: A Preliminary Novel Lapine Osteoarthritis Model." In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-205106.
Full textAbstract:
The meniscus plays a crucial role in the dynamics of the knee. Damage to the meniscus can influence proprioception, stability, and mobility of the knee [1]. Risk factors of meniscal tears include prolonged or repeated deep knee bending, obesity, and sporting injuries [2]. Acute injury, as seen in alpine sports, involves complex dynamics which can damage singular or multiple tissue structures of the knee [2]. It is not uncommon for meniscal injuries to occur in conjunction with ACL lesions, and the loading imbalance that results in ACL lesions may also initiate meniscal tears [3, 4]. Investigations of meniscal tears following ACL rupture have indicated chronic damage to medial menisci more so than lateral menisci [5]. However, experimental studies of acute damage following ACL transection are not consistent, with some showing more lateral damage acutely and some showing equality between medial and lateral meniscal damage [5].
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Di Gregorio, R., V. Parenti-Castelli, J. J. O’Connor, and A. Leardini. "Equivalent Spatial Parallel Mechanisms for the Modelling of the Ankle Passive Motion." In ASME 2004 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. ASMEDC, 2004. http://dx.doi.org/10.1115/detc2004-57251.
Full textAbstract:
The human ankle anatomical complex comprises the ankle and subtalar joints. The ankle represents the tibiotalar joint, connecting the tibia above, the fibula laterally and the talus below. Modelling of human joint passive motion is of great clinical relevance both for ligament reconstruction and for prosthesis design. The use of (equivalent) planar and spatial mechanisms for the kinematic modelling of joint passive motion proved to be a promising approach as it has been successfully utilized for the knee joint recently. Clinical evidence and experimental measurements led to infer that the relative passive motion between the tibia and the talus is a complex but single repeatable path constrained by articular surfaces and ligaments. The relative motion has the feature of a one degree of freedom rigid body guidance motion. Based on these considerations this paper presents two different equivalent spatial parallel mechanisms for this modelling. The mechanism links are taken from bones, ligaments and tendon structures, while kinematic pairs are appropriately chosen according to the corresponding type of anatomical connections. Simulation results are compared with corresponding experiments ones confirming the potential of the proposed approach.
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Lenoe, E. M. "Biomechanics Parameters for the Neck and Lumbar Spine: Some Implications for Advanced Materials and Other Emerging Technologies." In ASME 1996 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 1996. http://dx.doi.org/10.1115/imece1996-1287.
Full textAbstract:
Abstract A brief review is provided of characterization of the spine and of the various biomechanics models for the head/neck/spine system. This work was motivated by several biomechanics problems currently under consideration. First effort was to assess and discuss status of the leading intervertebral disc implants, and secondly to formulate numerous suitable dynamic models of biomechanical response, for example: for the “whiplash” problem, for a seated and helmeted crew member during a crash scenario, analysis of the High Altitude Low Opening Parachute (HALO) jump, and the effects of artillery fire on crews of combat vehicles . Therefore both quasi-static response and dynamic behavior were of interest. Characterization of the mechanical properties of the human body remains a challenge to biomedical engineers. The spine is a segmented structure containing \iscoelastic and kinematic elements. Efforts to characterize this complex structure have included in-vivo range of motion, head/neck response to forward, backward and lateral impact “jerks”, intervertebral disc pressure measurements, cadaveric whole spine tests, experiments on vertebrae and discs as well as isolated spinal ligament studies. With regard to crash survivability, a great deal of biodynamics research has been conducted and some general guidelines have been determined. But much more research is needed to provide accurate, proven figures. Whole body survival criteria have been derived based on test subjects seated with “correct” upright posture, and for single peak impacts. The magnitude, direction and duration of applied accelerative force have definite effects on human tolerance, as shown in a widely used data summary. For instance a spineward chest-back accelerative force of 45 G has been tolerated voluntarily when pulse duration is less than 0.044 seconds. However when the pulse duration increases to 0.2 seconds the tolerable force magnitude is 25 G. This paper reviews the readily available literature and concludes with parametric data for dynamic analysis of occupant response. Consideration of the available data indicates a wide range in mechanical properties of spinal ligaments, vertebrae and muscle groups. Coefficients of variance, cv, (standard deviation divided by mean value) were found to range as follows: Spinal ligament failure load cv’s from 30 to 85%, maximum deformation-35 to 72%, and stiffness from 33 to 84%; Vertebrae failure stresses from 44 to 64%, failure strains from 30 to 41%; Intervertebral discs with normal disc failure loads with c.v. of 10 % compared to 6% for degenerated discs, while cadaveric Spine failure loads variances were from 27 to 72%, and equivalent bilinear spine stiffness K1 had 40% and K2 62% variance. K1 = 101(40)[.40]**, K2 = 153(94)[.62] Newtons/mm. Range of motion and reflex times and neck strengths are observed to be influenced by sex and age. Both range of motion and neck strength decreased with aging. Coefficients of variance of male reflex times and strengths were found to be less variable than those of females, in the young and middle age groups. In general, male neck strengths were 1 1/2 to 2 times that of females. A recent study in Quebec of 5000 whiplash cases found that women are 50 % more likely than men to suffer whiplash injuries. The annual incidence of whiplash was found to be 86 per 100,000 for females compared with 54 for men. Mass moments of inertia, masses and associated centers of gravity and segment lengths are provided for a 50th percentile U.S. male aviator and for the “SOMLA” occupant man model. Regarding artificial intervertebral disc implants, review of the state-of-the-art indicates that no existing implants duplicate the full range of capabilities of the human disc or spine. As for crash survivable aircraft seats, civil aircraft, US Army helicopters and even NASA’s space shuttle crew seats could be significantly improved use of advanced materials, and properly design impact attenuation systems. The wide variation of spine strengths indicates the probabilistic design and analysis techniques should be applied. Finally it is evident that application of advanced composites and so-called smart materials must be based on an in-depth understanding of biomechanics and likely failure modes of the human body.