Abstract
Purpose
The purpose of this study is to research the effect of suture button (SB) fixation,
a method used at the treatment of ankle syndesmosis injury, which was applied in various
angles, pretension force, and levels, on the distal tibiofibular joint (DTFJ) in the
mid-stance phase, with the help of three-dimensional finite elements method (FEM)
Method
The ankle of a healthy individual was digitally analyzed by a finite element method-based
package computer program. Then, anterior inferior tibiofibular ligament (AITFL), interosseous
ligament, posterior inferior tibiofibular ligament (PITFL) and deltoid ligament (DL)
were cut and force and rotation has been applied to the proximal tibia, resulting
in syndesmosis injury. Then, various suture button applications on the injured model
have been analyzed. Three parameters have been changed; which were divergence in the
axial plane (20°, 30°, 40°), distance from the ankle (2, 3, 4 cm), and pretension force (200, 300, 600 N)
Results
As the result of this study, the rotation, change in the gap between the distal tibia
and distal fibula, and the displacements of the fibula in the x and y axes have been obtained, and numerical results were evaluated. As the force increased,
rotation, change in the gap between the distal tibia and distal fibula, and the displacements
of the fibula decreased. As suture button application rotation increased, change in
the gap between the distal tibia and distal fibula, and displacements of the fibula
increased. As the distance from the ankle increases and reaches a certain level, the
results converge to those of the healthy model; in the proximal, it diverges from
healthy results.
Conclusion
In the study, it has been shown that abnormal tibiofibular joint movements can be
prevented with suture button application, and optimum application parameters (divergence
in the axial plane, distance from the ankle, and pretension force) are given for proper
reduction.
Keywords
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Article info
Publication history
Published online: May 25, 2022
Accepted:
May 22,
2022
Editor: B NorrisIdentification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
