| ObjectiveThe purpose of this thesis is to acquire better knowledge of ankle-subtalar ligaments injuries, discuss the anatomy and the clinical significance of ankle-subtalar ligaments, study the mechanism of ankle-subtalar ligaments inversion injuries evaluate the value of stress test plain X-ray film, CT, MRI and arthroscopy in the diagnosis of ankle-subtalar ligaments injuries. Three approaches were used: anatomy, biomechanics and imagine. The knowledge is intended to serve as a basis development of diagnosis and reconstruction of ankle-subtalar ligaments injuries.Materials and MethodsIn the anatomic approach, the ankle lateral ligaments, subtalar ligaments and related reconstructive tendons and ligaments that could be transferred were studied on 32 leg-foot specimens. 25 dry foot bone specimens were used. The artery supply around ankle joint and sinus tarsi were studied in the same time. Several reconstuctive operations were imitated in the cadaver. In the biomechanical approach, 7 cases of fresh-frozen ankle- foot specimens were injured imitated the clinical injury of ankle-subtalar joint inversion in the MTS, the 3-D dimension motion of the subtalar joint of 6 cases of fresh injured specimens in the 3-D motion apparatus, the inferior tibia-fibular syndesmosis injury were studied on 8 cases fresh leg specimens in SWD10 material test apparatus. In the imaging approach, the 6 cases injured ankle-subtalar complexes specimens were examined with X-ray, CT, MRI and arthroscrpy, The results were compared with anatomy of the injured specimens, and 4 cases patients of ankle inversion injured were examined with X-ray, CT compared with found during operation.ResultAnterior talofibular ligament areas of attachments is located in the range 1 cm of superior-anterior lateral malleolus, forward and medially, to the superior-lateral neck of talus, in front of its lateral articular facet. The calcaneofibular ligament, the longest of the three, is a narrow, rounded cord,running from the apex of the fibular malleolus downward and slightly backward to a tubercle on the lateral surface of the calcaneus. It is covered by the tendons of the Peronasi longus and birevis. Cervical ligament extends from the front and lateral surface of the neck of the talus to the superior surface of the calcaneus. It forms the posterior boundary of the talocalcaneonavicular joint, and is sometimes described as the anterior interosseous ligament. The posterior talocalcaneal ligament connects the lateral tubercle of the talus with the upper and medial part of the calcaneus; it include two crass short band, and its fibers radiate from their narrow attachment to the talus.The locations of the extensor longus tendon of little toe, the peroneus brevis tendon, the peroneus tertius tendon and the inferior extensor retinaculum were near the lateral ankle and subtalar ligaments; There were enough of length, width and thickness to reconstruct the lateral ankle and subtalar ligaments.The sinus tarsi is a conical shaped cavity located between the anterosuperior surface of the calcaneus and the inferior aspect of the neck of the talus. It opens laterally, anterior to the fibular malleolus and terminates posteromedially directly behind the sustentaculum tali. The contents of the sinus tarsi include interosseous talocalcaneal ligament and cervical ligament, medial, inferior and lateral roots of the inferior extensor retinaculum,artery and venous of the tarsal canal, filled with fat tissue.The ankle artery supply could be divided into the anterior, lateral- posterior and medial-posterior three areas, there are sufficient communicating branches among three areas.In the ankle-subtalar joint inversion injuries, the Anterior talofibular ligament was injured firstly when ankle was plantarflexion, second was calcaneofibular ligament, when ankle joint was dorsiflexion, calcaneofibular ligament was injured firstly, secondly was talofibular ligament, the last injured in both situation were subtalar ligaments. The 3-D motion of subtalar joint...
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