RESUMO
INTRODUCTION: The purpose of this work is perform a biomechanical comparison of anatomic reconstruction of the anterior talofibular ligament (ATFL) with the intact ATFL. MATERIALS AND METHODS: We studied 18 fresh cadaveric ankles with intact ATFL. Each specimen was clinically assessed with the anterior drawer (AD) and varus tilt (VT) tests and the angular movement in the three spatial planes (axial, coronal and sagittal) was measured with an arthrometer using a sensor located in the talus. RESULTS: Statistically significant differences were found in the axial plane, between the intact ATFL versus the sectioned ATFL for AD test with p = 0.012, and for VT test with p = 0.013. Regarding the coronal plane, we also observed a statistically significant difference for VT test with p = 0.016. In the sagittal plane, there are no statistically significant differences in both maneuvers. No statistically significant differences were found when comparing the biomechanics of anatomic ligament reconstruction versus the intact ATFL. CONCLUSION: Autograft anatomic reconstruction of the ATFL showed biomechanical properties similar to those of the native ATFL, at the zero moment in a cadaveric model.
RESUMO
The fibularis tertius muscle (FTM) in man has been developed over time to acquire subsequent bipedal gait. The FTM functions as a crucial contributor in dorsiflexion and eversion, postulated over the years as a stabilizer of the talocrural joint, avoiding forced investment and protecting the anterior talofibular ligament. The literature describes that FTM is absent in 10 percent of cases, with no data on Chilean population. A study of surface anatomy in 168 young subjects, 60 percent female and 40 percent male students at the Universidad de Talca, Chile, with a mean age of 20.6 +/- 1.68 years, was conducted. The presence of FTM was identified following the implementation of a clinical assessment protocol that determines the presence of muscle on the basis of a progression called F1, F2, and F3. The FTM was present in 49.11 percent of cases. On the right side, 20 percent (n = 37) of the subjects presented the FTM in F2 and 30 percent (n = 50) in F3. On the left side, 1 percent (n = 2) showed the muscle in F1, 21 percent (n = 35) in F2, and 26 percent (n = 44) in F3. Our results contrast with the high prevalence of FTM in the literature and suggest studies of association with lesions of the talocrural region.
El músculo fibular tercero (MFT) es un músculo que en el hombre se ha desarrollado paulatinamente, al adquirir la posición bípeda y posteriormente la marcha. Dentro de las funciones del MFT destaca su contribución en la flexión dorsal y eversión, postulándose que actuaría como estabilizador de la articulación talocrural, al evitar la inversión forzada y proteger al ligamento talofibular anterior. La literatura describe que el MFT se encuentra ausente en un 10 por ciento de los casos, no existiendo datos de la población chilena. Se realizó un estudio de anatomía de superficie en 168 sujetos jóvenes, el 60 por ciento de sexo femenino y 40 por ciento de sexo masculino, estudiantes de la Universidad de Talca, Chile, con edad promedio de 20,6 +/- 1,68 años. La presencia del MFT se identificó tras la aplicación de un protocolo de evaluación clínica que determina la presencia del músculo en base a una progresión denominada F1, F2, F3. El MFT estuvo presente en el 49,11 por ciento de los casos. En el lado derecho el 20 por ciento (n=37) de los sujetos presenta el MFT en F2 y un 30 por ciento (n=50) en F3. En el lado izquierdo un 1 por ciento (n=2) exhibe el músculo en F1, 21 por ciento (n=35) en F2 y un 26 por ciento(n=44) en F3. Nuestros resultados contrastan con la alta prevalencia del MFT descrita en la literatura y se sugiere la realización de estudios de asociación con las lesiones de la región talocrural.
