{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T06:53:14Z","timestamp":1763535194459,"version":"3.38.0"},"reference-count":11,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2012,9,1]],"date-time":"2012-09-01T00:00:00Z","timestamp":1346457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:p> Background: Syndesmosis (high ankle) sprains produce disruption of the distal tibiofibular ligaments. Forces on the distal fibula that produce these injuries are unknown. Methods: Twenty-seven fresh-frozen lower extremities were used for this study. A load cell recorded forces acting on the distal fibula from forced ankle dorsiflexion and applied external foot torque; medial-lateral and anterior-posterior displacements of the distal fibula were recorded. Fibular forces and axial displacements were also recorded with applied axial force. Results: During forced ankle dorsiflexion and external foot torque tests, the distal fibula always displaced posteriorly with respect to the tibia with no measurable medial-lateral displacement. With 10 Nm dorsiflexion moment, cutting the tibiofibular ligaments approximately doubled fibular force and displacement values. Cutting the tibiofibular ligaments significantly increased fibular displacement from applied external foot torque. Fibular forces and axial displacements from applied axial weight-bearing force were highest with the foot dorsiflexed. The highest mean fibular force in the study (271.9 N) occurred with 10 Nm external foot torque applied to a dorsiflexed foot under 1000 N axial force. Conclusions: Two important modes of loading that could produce high ankle sprains were identified: forced ankle dorsiflexion and external foot torque applied to a dorsiflexed ankle loaded with axial force. The distal tibiofibular ligaments restrained fibular displacement during these tests. Clinical Relevance: Residual mortise widening observed at surgery may be the result of tibiofibular ligament injuries caused by posterior displacement of the fibula. Therefore, a syndesmosis screw used to fix the fibula would be subjected to posterior bending forces from these loading modes. Ankle bracing to prevent extreme ankle dorsiflexion during rehabilitation may be advisable to prevent excessive fibular motions that could affect syndesmosis healing. <\/jats:p>","DOI":"10.3113\/fai.2012.0779","type":"journal-article","created":{"date-parts":[[2012,10,4]],"date-time":"2012-10-04T18:21:55Z","timestamp":1349374915000},"page":"779-786","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Force and Displacement Measurements of the Distal Fibula during Simulated Ankle Loading Tests for High Ankle Sprains"],"prefix":"10.1177","volume":"33","author":[{"given":"Keith L.","family":"Markolf","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, UCLA, Los Angeles, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, UCLA, Los Angeles, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"McAllister","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, UCLA, Los Angeles, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,9,1]]},"reference":[{"issue":"5","key":"bibr1-FAI.2012.0779","first-page":"304","volume":"126","author":"Bragonzoni L","year":"2006","journal-title":"RSA-based study on intact, ligament injured and screw fixed cadaver specimens. Arch Orthop Trauma Surg"},{"issue":"3","key":"bibr2-FAI.2012.0779","first-page":"425","volume":"46","author":"Cedell CA","year":"1975","journal-title":"Acta Orthop Scand"},{"key":"bibr3-FAI.2012.0779","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199206000-00028"},{"key":"bibr4-FAI.2012.0779","doi-asserted-by":"publisher","DOI":"10.1177\/107110079001000607"},{"key":"bibr5-FAI.2012.0779","doi-asserted-by":"publisher","DOI":"10.1016\/0020-1383(83)90007-4"},{"issue":"4","key":"bibr6-FAI.2012.0779","first-page":"557","volume":"72","author":"Markolf KL","year":"1990","journal-title":"An in vitro study performed with a new experimental technique. J Bone Joint Surg Am"},{"issue":"1","key":"bibr7-FAI.2012.0779","first-page":"68","volume":"36","author":"Norkus SA","year":"2001","journal-title":"J Athl Train"},{"key":"bibr8-FAI.2012.0779","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198404000-00047"},{"key":"bibr9-FAI.2012.0779","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199609000-00034"},{"key":"bibr10-FAI.2012.0779","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507302545"},{"issue":"6","key":"bibr11-FAI.2012.0779","first-page":"847","volume":"77","author":"Xenos JS","year":"1995","journal-title":"Evaluation of the ligamentous structures, methods of fixation, and radiographic assessment. J Bone Joint Surg Am"}],"container-title":["Foot &amp; Ankle International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3113\/FAI.2012.0779","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.3113\/FAI.2012.0779","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3113\/FAI.2012.0779","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T22:01:45Z","timestamp":1741644105000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.3113\/FAI.2012.0779"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,9]]},"references-count":11,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2012,9]]}},"alternative-id":["10.3113\/FAI.2012.0779"],"URL":"https:\/\/doi.org\/10.3113\/fai.2012.0779","relation":{},"ISSN":["1071-1007","1944-7876"],"issn-type":[{"type":"print","value":"1071-1007"},{"type":"electronic","value":"1944-7876"}],"subject":[],"published":{"date-parts":[[2012,9]]}}}