PURPOSE To assess the impact on ankle stability after repairing the ATFL alone compared to repairing both the ATFL and CFL in a biomechanical cadaver model. METHODS Ten matched pairs of intact, fresh frozen human cadaver ankles (normal) were mounted to a test machine in 20.0° plantar flexion and 15.0° of internal rotation. Each ankle was loaded to body weight and then tested from 0.0° to 20.0° of inversion. The data recorded were torque at 20.0° and stiffness, peak pressure and contact area in the ankle joint using a Tekscan sensor, rotation of the talus and calcaneus, and translation of the calcaneus using a three-dimensional motion capture system. Ankles then underwent sectioning of the ATFL and CFL (injured), retested, then randomly assigned to ATFL-only Broström repair or combined ATFL and CFL repair. Testing was repeated after repair then loaded in inversion to failure (LTF). RESULTS The stiffness of the ankle was not significantly increased compared to the injured condition by repairing the ATFL only (n.s.) or the ATFL/CFL (n.s.). The calcaneus had significantly more rotation than the injured condition in the ATFL-only repair (p = 0.037) but not in the ATFL/CFL repair (n.s.). The ATFL failed at 40.3% higher torque than the CFL, at 17.4 ± 7.0 N m and 12.4 ± 4.1 N m, respectively, and 62.0% more rotation, at 43.9 ± 5.6° and 27.1 ± 6.8°, respectively. CONCLUSIONS There was a greater increase in stiffness following combined ATFL/CFL repair compared to ATFL-only repair, although this did not reach statistical significance. The CFL fails before the ATFL, potentially indicating its vulnerability immediately following repair. LEVEL OF EVIDENCE III, case-control therapeutic study.

中文翻译：

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在生物力学尸体模型中，联合韧带修复后，CFL在ATFL之前立即失效。

目的评估与单独修复ATFL和CFL相比在生物力学尸体模型中单独修复ATFL后对踝关节稳定性的影响。方法将十对匹配的完整，新鲜的冷冻人尸体脚踝（正常）以20.0°足底屈曲和15.0°内旋度安装到试验机上。将每个脚踝加载至体重，然后在0.0°至20.0°的内翻角度进行测试。记录的数据包括使用Tekscan传感器在20.0°处的扭矩和刚度，峰值压力和踝关节中的接触面积，距骨和跟骨的旋转以及使用三维运动捕捉系统的跟骨的平移。然后对脚踝进行ATFL和CFL的切片（受伤），重新测试，然后随机分配给仅用于ATFL的Broström修复或将ATFL和CFL合并进行修复。维修后重复测试，然后加载为失败转换（LTF）。结果通过仅修复ATFL（ns）或ATFL / CFL（ns），与受伤情况相比，踝关节的僵硬程度并未显着增加。在仅进行ATFL的修复中，跟骨的旋转比受伤的情况要多得多（p = 0.037），但在进行ATFL / CFL的修复中，跟骨的旋转则没有（ns）。ATFL的扭矩比CFL高40.3％，分别在17.4±7.0 N m和12.4±4.1 N m处失效，而旋转强度分别在43.9±5.6°和27.1±6.8°时增加62.0％。结论与仅进行ATFL / CFL修复相比，联合进行ATFL / CFL修复后的刚度增加更大，尽管这没有统计学意义。CFL在ATFL之前发生故障，可能表明修复后立即存在漏洞。