Influence of ankle joint plantarflexion and dorsiflexion on lateral ankle sprain: A computational study

Abstract

Understanding the mechanism of injury involved in lateral ankle sprain is essential to prevent injury, to establish surgical repair and reconstruction, and to plan reliable rehabilitation protocols. Most studies for lateral ankle sprain posit that ankle inversion, internal rotation, and plantarflexion are involved in the mechanism of injury. However, recent studies indicated that ankle dorsiflexion also plays an important role in the lateral ankle sprain mechanism. In this study, the contributions of ankle plantarflexion and dorsiflexion on the ankle joint were evaluated under complex combinations of internal and inversion moments. A multibody ankle joint model including 24 ligaments was developed and validated against two experimental cadaveric studies. The effects of ankle plantarflexion (up to 60°) and dorsiflexion (up to 30°) on the lateral ankle sprain mechanism under ankle inversion moment coupled with internal rotational moment were investigated using the validated model. Lateral ankle sprain injuries can occur during ankle dorsiflexion, in which the calcaneofibular ligament and anterior talofibular ligament tears may occur associated with excessive inversion and internal rotational moment, respectively. Various combinations of inversion and internal moment may lead to anterior talofibular ligament injuries at early ankle plantarflexion, while the inversion moment acts as a primary factor to tear the anterior talofibular ligament in early plantarflexion. It is better to consider inversion and internal rotation as primary factors of the lateral ankle sprain mechanism, while plantarflexion or dorsiflexion can be secondary factor. This information will help to clarify the lateral ankle sprain mechanism of injury.

Multibody modelling of the foot for the biomechanical analysis of the ankle joint during running: A narrative review

“…In 2018, Purevsuren et al 69 developed a foot model to understand the lateral ankle sprain mechanisms. The model, with the geometrical data retrieved from a digital database and imported to the multibody dynamic analysis software RecurDyn (Function Bay, Inc., Seongnam, Korea) included 28 bones – tibia; fibula; calcaneus; talus; navicular; cuboid; 3 cuneiforms; 5 metatarsals; and proximal, medial, and distal phalanges – and 24 ligaments – anterior and posterior talofibular; calcaneofibular; anterior and posterior tibiofibular; anterior and posterior tibiotalar; tibionavicular; talonavicular (two bundles); lateral, medial, posterior and interosseous talocalcaneal (two bundles); tibiocalcaneal; and the interosseous ligament between the tibia and fibula (eight bundles).…”

Effect of ball position on the risk of injury to the lower limb joints during the hockey sweep pass in women

“…These results have demonstrated that the ball placed in front resulted in high dorsiflexion and adduction moments. Therefore, this position places the ankle, especially the lateral structures, at an increased risk of injury 13–16 20. However, positioning the ball behind increased the risk of damage to the medial structures and positioning the ball in line resulted in a high dorsiflexion moment.…”

An inverted ankle joint orientation at foot strike could incite ankle inversion sprain: Comparison between injury and non-injured cutting motions of a tennis player

“…Successful injury prevention depends on the understanding of injury mechanisms 7 , which can be studied by various methods 8 . Lateral ankle sprain injury has been commonly studied by video analysis 9 , subinjury simulation 10 , cadaveric test 11 and computational modelling 12 , however, all of these are indirect approaches as studying real injury in a biomechanics laboratory with intention is unethical and also practically very difficult. Since 2009, various research groups reported the biomechanics of lateral ankle sprain injury or giving way from forensic analysis on real incidents captured from televised events or laboratory trials [13][14][15][16][17][18][19][20][21][22] .…”