Biomechanical finite element analysis of lower tibiofibular ligament

doi:10.12307/2022.723

Abstract

Abstract: BACKGROUND: The lower tibiofibular ligament plays a great role in maintaining the stability of the ankle. Now more and more scholars begin to pay attention to the biomechanical research of the lower tibiofibular ligament, but there are few reports on the biomechanical research of the lower tibiofibular anterior ligament, interosseous ligament, lower tibiofibular posterior ligament, and transverse ligament alone.
OBJECTIVE: To establish a three-dimensional finite element simulation model of ankle joint including lower tibiofibular ligament, distal tibiofibula, and talus and study the effect of lower tibiofibular ligament on ankle joint stability.
METHODS: Based on the image information of computed tomography, combined with Mimics software and Geomagic Studio software, the ankle joint simulation model including tibia, fibula, talus, and some cartilages was established, and then the model was imported into the finite element analysis software Abaqus, so as to construct the three-dimensional finite element model of ankle joint including ligament and other soft tissues. Finally, the specific changes of stress distribution and displacement of anterior tibiofibular ligament, interosseous ligament, posterior tibiofibular ligament, and transverse ligament under four different types of stress environments were simulated.
RESULTS AND CONCLUSION: (1) The posterior tibiofibular ligament was the most stressed under internal rotation load. Under external rotation load, the stress of transverse tibiofibular ligament was the largest, followed by anterior tibiofibular ligament. Under vertical + internal rotation load, the stress of posterior tibiofibular ligament was the largest, but the maximum stress value increased compared with simple internal rotation load. Under the vertical + external rotation load, the stress of the lower tibiofibular transverse ligament was the largest, followed by the lower tibiofibular anterior ligament, but the maximum stress value increased compared with the simple external rotation load. (2) It is concluded that posterior tibiofibular ligament plays a prominent role in preventing ankle pronation injury. The lower tibiofibular transverse ligament and anterior ligament play a prominent role in preventing ankle external rotation injury.

Key words: lower tibiofibula, ligament, biomechanics, finite element analysis, ankle joint, three-dimensional finite element model, biomechanics

CLC Number:

Ding Junwen, Mi Tao, Li Zeqing, Ren Rong, Tang Baoming, Luo Wei, Li Zhaowei. Biomechanical finite element analysis of lower tibiofibular ligament[J]. Chinese Journal of Tissue Engineering Research, 2022, 26(33): 5259-5264.

Figures/Tables 2

References

[1] 王满宜.关于踝关节骨折伴下胫腓联合损伤的思考[J].中华创伤骨科杂志,2017,19(9):737-738.
[2] PORTER DA, JAGGERS RR, BARNES AF, et al. Optimal management of ankle syndesmosis injuries. Open Access J Sports Med. 2014;5:173-182.
[3] LIU GT, RYAN E, GUSTAFSON E, et al. Three-dimensional computed tomographic characterization of normal anatomic morphology and variations of the distal tibiofibular syndesmosis. J Foot Ankle Surg. 2018;57(6):1130-1136.
[4] IVINS D. Acute ankle sprain: an update. Am Fam Physician. 2006;74(10): 1714-1720.
[5] SUMANONT S, NOPAMASSIRI S, BOONROD A, et al. Acromioclavicular joint dislocation: a Dog Bone button fixation alone versus Dog Bone button fixation augmented with acromioclavicular repair—a finite element analysis study. Eur J Orthop Surg Traumatol. 2018;28(6):1095-1101.
[6] CHEUNG TM, ZHANG M, LEUNG KL, et al. Three-dimensional finite element analysis of the foot during standing—a material sensitivity study. J Biomech. 2005;38(5):1045-1054.
[7] CHEN FC, HUANG XW, YA YS, et al. Finite element analysis of intramedullary nailing and double locking plate for treating extra-articular proximal tibial fractures. J Orthop Surg Res. 2018;13(1):2-8.
[8] ATMACA H, OZKAN A, MATLA I, et al. The effect of proximal tibial corrective osteotomy on menisci tibia and tarsal bones: A finite element model study of tibia vara. Int J Med Robot. 2014;10(1):93-97.
[9] 刘清华.数字化人体足踝部三维有限元模型的建立及分析[D].广州:南方医科大学,2010.
[10] ANDERSON DD, GOLDSWORTHY JK, LI W, et al. Physical validation of a patient-specific contact finite element model of the ankle. J Biomech. 2007;40(8):1662-1669.
[11] 毕刚,陈大伟,李春光,等.下胫腓联合损伤对踝关节稳定性影响的生物力学研究[J].中国矫形外科杂志,2017,25(20):1881-1885.
[12] LIACOURAS PC, WAYNE JS. Computational modeling to predict mechanical function of joints: application to the lower leg with simulation of two cadaver studies.J Biomech Eng. 2007;129(6):811-817.
[13] 林健.下胫腓前韧带的功能与损伤修复[D].南京:南京医科大学, 2017.
[14] HERMANS JJ, BEUMER A, DE JONG TA, et al. Anatomy of the distal tibiofibular syndesmosis in adults: a pictorial essay with a multimodality approach. J Anat. 2010;217(6):633-645.
[15] LILYQUIST M, SHAW A, LATZ K, et al. Cadaveric analysis of the distal tibiofibular syndesmosis. Foot Ankle Int. 2016;37(8): 882-890.
[16] XENOS JS, HOPKINSON WJ, MULLIGAN ME, et al.The tibiofibular syndesmosis.Evaluation of the ligamentous structures,methods of fixation,and radiographic assessment. J Bone Joint Surg Am. 1995; 77(6):847-856.
[17] 王军,张铁骑,何益群,等.3D 打印踝穴位支具辅助术中透视评估下胫腓联合分离的应用价值[J].中国骨与关节损伤杂志,2020,35(6): 643-644.
[18] CLANTON TO, PAUL P. Syndesmosis injuries in athletes. Foot Ankle Clin. 2002;7(3):529-549.
[19] MORRIS M, RICE P, SCHNEIDER TE. Distal tibiofibular syndesmosis reconstruction using a free hamstring autograft. Foot Ankle Int. 2009; 30(6):506-511.
[20] PEA FA, CHRIS COETZEE J. Ankle Syndesmosis Injuries-ScienceDirect. Foot Ankle Clin. 2006;11(1):35-50.
[21] RAMMELT S, ZWIPP H, GRASS R. Injuries to the Distal Tibiofibular Syndesmosis: an Evidence-Based Approach to Acute and Chronic Lesions. Foot Ankle Clin. 2008;13(4):611-633.
[22] THORDARSON DB, MOTAMED S, HEDMAN T, et al. The effect of fibular malreduction on contact pressures in an ankle fracture malunion model. J Bone Joint Surg Am. 1998;79(12):1809-1815.
[23] VAN HEEST TJ, LAFFERTY PM. Injuries to the ankle syndesmosis. J Bone Joint Surg (Am). 2014;96(7):603-613.
[24] MILLER TL, SKALAK T. Evaluation and treatment recommendations for acute injuries to the ankle syndesmosis without associated fracture. Sports Med. 2014;44(2):179-188.
[25] CLANTON TO, WILLIAMS BT, BACKUS JD, et al. Biomechanical analysis of the individual ligament contributions to syndesmotic stability. Foot Ankle Int. 2017;38(1):66-75.
[26] SNEDDEN MH, SHEA JP. Diastasis with low distal fibula fractures: an anatomic rationale. Clin Orthop Relat Res. 2001;(382):197-205.
[27] BEUMER A, HEMERT W, SWIERSTRA BA, et al. A biomechanical evaluation of the tibiofibular and tibiotalar ligaments of the ankle. Foot Ankle Int. 2003;24(5):426-429.
[28] GARDNER MJ, BRODSKY A, BRIGGS SM, et al. Fixation of posterior malleolar fractures provides greater syndesmotic stability. Clin Orthop Relat Res. 2006;447(447):165-171.
[29] VAN HEEST TJ, LAFFERTY PM. Injuries to the ankle syndesmosis. J Bone Joint Surg Am. 2014;96(7):603-613.
[30] KIM YJ, LEE JH. Posterior Inferior Tibiofibular Ligament Release to Achieve Anatomic Reduction of Posterior Malleolar Fractures. J Foot Ankle Surg. 2018;57(1):86-90.
[31] XU D, WANG Y, JIANG C, et al. Strain distribution in the anterior inferior tibiofibular ligament, posterior inferior tibiofibular ligament, and nterosseous membrane using digital imagecorrelation. Foot Ankle Int. 2018;39(5):618-628.
[32] 黄云鹏,王滨,李靖年,等.下胫腓前韧带撕裂对胫距关节面生物力学的影响[J].中国骨伤,2012,25(8):658-661.
[33] HOEFNAGELS EM, WAITES MD, WING ID, et al. Biomechanical comparison of the interosseous tibiofibular ligament and the anterior tibiofibular ligament. Foot Ankle Int. 2007;28(5):602-604.