Zusammenfassung:
Es wird über eine experimentelle Untersuchung in einem biostatischen Modell berichtet,
in dem der Gelenkflächendruck des oberen Sprunggelenks in Abhängigkeit von verschiedenen
Gelenkstellungen und lateralen Bandläsionen unter axialer Belastung gemessen wurde.
Die Ergebnisse zeigen, daß Druckmaxima unter Varus- und Supinationsposition am medialen
Talusrand liegen, dort wo die Osteochondrosis dissecans tali besonders häufig auftritt.
Im Zusammenhang damit wird die Ätiologie und Pathogenese der Osteochondrosis dissecans
tali diskutiert und der hohe Stellenwert des Supinationstraumas hervorgehoben.
Abstract
In a cadaveric biostatic model the pressure distribution at the weightbearing ankle
has been investigated under different joint positions and stages of artificial lateral
ligament dissection mimicking a supination trauma. The location of the transduced
contact area, the size of these areas and amount of pressure were evaluated after
application of axial load. The results showed that the location, size of contact area
and the maximum transduced pressure were depending on the joint Position and stage
of ligament dissection. Interestingly the peak pressure was located at the medial
talar rim even without lateral ligament dissection. The transduced pressure areas
were located at that locations were osteochondral lesions are mostly observed. In
regard to these results the etiology and pathogenesis of osteochondritis dissecans
tali is discussed. It is thought that supination traumas as well as other biomechanical
factors such as overweight and lax ankle ligaments have an important influence on
the development of osteochondritis dissecans at least at the medial rim of the talus.
