This content is not included in your SAE MOBILUS subscription, or you are not logged in.
Injury Tolerance and Response of the Ankle Joint in Dynamic Dorsiflexion
Technical Paper
2004-22-0001
Annotation ability available
Sector:
Language:
English
Abstract
Forced dorsiflexion in frontal vehicle crashes is considered a common cause of injury to the ankle joint. Although a few studies have been published on the dynamic fracture tolerance of the ankle in dorsiflexion, this work reexamines the topic with increased statistical power, adds an evaluation of articular cartilage injury, and utilizes methods to detect the true time of fracture. The objective of this study was to measure the response and injury tolerance of the human ankle in a loading condition similar to that found in a vehicle crash with toepan intrusion. A test fixture was constructed to apply forefoot impacts to twenty cadaveric lower limbs, that were anatomically intact distal to the femur mid-diaphysis. Specimen instrumentation included implanted tibial and fibular load cells, accelerometers, angular rate sensors, and an acoustic sensor. Following the tests, specimens were radiographed and dissected to determine the extent of injury. Eleven of the twenty specimens sustained fracture of the ankle joint. Fractures of the medial malleolus were the most common, while two specimens sustained bimalleolar fractures, and two a talar neck fracture. Other injuries included ligament tears, osteochondral fractures, and cartilage abrasions. Analysis of the acoustic emission indicated that fracture did not always occur at the peak ankle moment. Based on the results of this study, an ankle joint moment of 59 N-m represents a 25% risk of ankle fracture in dorsiflexion for a 50th percentile male. When applied to the Thor-Lx dummy, the 25% risk of injury occurs at 36° of dorsiflexion as measured by the ankle potentiometer.
Recommended Content
Authors
- Rodney Rudd - University of Virginia Center for Applied Biomechanics
- Jeff Crandall - University of Virginia Center for Applied Biomechanics
- Steven Millington - University of Virginia Center for Applied Biomechanics
- Shepard Hurwitz - University of Virginia Center for Applied Biomechanics
- Niklas Höglund - Chalmers University of Technology
Topic
Citation
Rudd, R., Crandall, J., Millington, S., Hurwitz, S. et al., "Injury Tolerance and Response of the Ankle Joint in Dynamic Dorsiflexion," SAE Technical Paper 2004-22-0001, 2004, https://doi.org/10.4271/2004-22-0001.Also In
References
- Athanasiou, K.A., Niederauer, G.G., and Schenck, R.C. (1995) Biomechanical Topography of Human Ankle Cartilage. Annals of Biomedical Engineering 23: 697–704.
- Atkinson, P.J. and Haut, R.C. (1995) Subfracture Insult to the Human Cadaver Patellofemoral Joint Produces Occult Injury. Journal of Orthopaedic Research 13(6): 936–944.
- Azangwe, G., Fraser, K., Mathias, K.J., and Siddiqui, A.M. (2000) In vitro Monitoring of Rabbit Anterior Cruciate Ligament Damage by Acoustic Emission. Medical Engineering & Physics 22: 279–283.
- Begeman, P.C., and Prasad, P. (1990) Human Ankle Impact Response in Dorsiflexion. Proceedings of the 34th Stapp Car Crash Conference, pp. 39–53. Society of Automotive Engineers, Warrendale, PA.
- Crandall, J.R., Portier, L., Petit, P., Hall, G.W., Bass, C.R., Klopp, G.S., Hurwitz, S., Pilkey, W.D., Trosseille, X., Tarrière, C., and Lassau, J. (1996) Biomechanical Response and Physical Properties of the Leg, Foot, and Ankle. Proceedings of the 40th Stapp Car Crash Conference, pp. 173–192. Society of Automotive Engineers, Warrendale, PA.
- Devore, J.L. (1995) Probability and Statistics for Engineering and the Sciences. Duxbury Press, Pacific Grove.
- Dischinger, P.C., Burgess, A.R., Cushing, B.M., O’Quinn, T.D., Schmidhauser, C.B., Ho, S.M., Juliano, P.J., and Bents, F.D. (1994) Lower Extremity Trauma in Vehicular Front-Seat Occupants: Patients Admitted to a Level 1 Trauma Center. SAE International Congress and Exposition, paper no. 940710. Society of Automotive Engineers, Warrendale, PA.
- Eppinger, R.H., Marcus, J.H., and Morgan, R.M. (1984) Development of Dummy and Injury Index for NHTSA’s Thoracic Side Impact Protection Research Program. SAE Government/Industry Meeting and Exposition, paper no. 840885. Society of Automotive Engineers, Warrendale, PA.
- Fleming, B.C., Peura, G.D., and Beynnon, B.D. (2000) Factors Influencing the Output of an Implantable Force Transducer. Journal of Biomechanics 33: 889–893.
- Funk, J.R., Crandall, J.R., Tourret, L.J., MacMahon, C.B., Bass, C.R., Khaewpong, N., and Eppinger, R.H. (2001) The Effect of Active Muscle Tension on the Axial Injury Tolerance of the Human Foot/Ankle Complex. Proceedings of the 17th International Technical Conference on the Enhanced Safety of Vehicles.
- Funk, J.R., Rudd, R.W.,Srinivasan, S.C.M., King, R.J., Crandall, J.R., and Petit, P.Y. (2002a) Methodology for Measuring Tibial and Fibular Loads in a Cadaver. SAE International Congress and Exposition, paper no. 2002-01-0682. Society of Automotive Engineers, Warrendale, PA.
- Funk, J.R., Srinivasan, S.C.M., Crandall, J.R., Khaewpong, N., Eppinger, R.H., Jaffredo, A.S., Potier, P., and Petit, P.Y. (2002b) The Effects of Axial Preload and Dorsiflexion on the Tolerance of the Ankle/Subtalar Joint to Dynamic Inversion and Eversion. Stapp Car Crash Journal 46: 245–265.
- Hall, G.W., Crandall, J.R., Klisch, S.M., Klopp, G.S., and Pilkey, W.D. (1996) Measurement of Dynamic Joint Motion Using Magnetohydrodynamic Angular Rate Sensors. The Shock and Vibration Digest 28(5): 12–17.
- Hall, G.W., Crandall, J.R., Carmines, D.V., and Hale, J.E. (1999) Rate-independent Characteristics of an Arthroscopically Implantable Force Probe in the Human Achilles Tendon. Journal of Biomechanics 32: 203–207.
- Hanagud, S., Clinton, R.G., and Lopez, J.P. (1973) Acoustic Emission in Bone Substance. Proceedings of the Biomechanics Symposium of the ASME, p. 74. American Society of Mechanical Engineers, New York, NY.
- Hollander, M. and Proschan, F. (1979) Testing to Determine the Underlying Distribution Using Randomly Censored Data. Biometrics 35: 393–401.
- Johnson, D.L., Urban, W.P., Caborn, D.N., Vanarthos, W.J., and Carlson, C.S. (1998) Articular Cartilage Changes Seen with Magnetic Resonance Imaging-Detected Bone Bruises Associated with Acute Anterior Cruciate Ligament Rupture. American Journal of Sports Medicine 26(3): 409–414.
- Kuppa, S., Haffner, M., Eppinger, R., and Saunders, J. (2001a) Lower Extremity Response and Trauma Assessment Using the Thor-Lx/HIIIr and the Denton Leg in Frontal Offset Vehicle Crashes. Proceedings of the 17th International Technical Conference on the Enhanced Safety of Vehicles.
- Kuppa, S., Wang, J., Haffner, M., and Eppinger, R. (2001b) Lower Extremity Injuries and Associated Injury Criteria. Proceedings of the 17th International Technical Conference on the Enhanced Safety of Vehicles.
- Manning, P., Wallace, A., Owen, C., Roberts, A., Oakley, C., and Lowne, R. (1998) Dynamic Response and Injury Mechanism in the Human Foot and Ankle and an Analysis of Dummy Biofidelity. Proceedings of the 16th Technical Conference on the Enhanced Safety of Vehicles, pp. 1960–1998.
- Martin, P.G., Crandall, J.R., Pilkey, W.D., and Miller, T.R. (1997) Passenger Car Drivers: Annual Injury Incidence and Costs Projected to 2005. 41st Annual Proceedings of the Association for the Advancement of Automotive Medicine, pp. 249–263.
- Morgan, R.M., Eppinger, R.H., and Hennessey, B.C. (1991) Ankle Joint Injury Mechanism for Adults in Frontal Automotive Impact. Proceedings of the 35th Stapp Car Crash Conference, pp. 189–198. Society of Automotive Engineers, Warrendale, PA.
- Newberry, W.N., Garcia, J.J., Mackenzie, C.D., Decamp, C.E., and Haut, R.C. (1998) Analysis of Acute Mechanical Insult in an Animal Model of Post-Traumatic Osteoarthritis. Journal of Biomechanical Engineering 120: 704–709.
- Owen, C., Lowne, R., and McMaster, J. (2001) Requirements for the Evaluation of the Risk of Injury to the Ankle in Car Impact Tests. Proceedings of the 17th International Technical Conference on the Enhanced Safety of Vehicles.
- Parenteau, C.S., Viano, D.C., and Lövsund, P. (1995) Foot-Ankle Injury Epidemiological and Biomechanical Studies. International Conference on Pelvic and Lower Extremity Injuries Proceedings, pp. 191–200. NHTSA, Washington, DC.
- Parenteau, C.S., Viano, D.C., and Petit, P.Y. (1998) Biomechanical Properties of Human Cadaveric Ankle-Subtalar Joints in Quasi-Static Loading. Journal of Biomechanical Engineering 120: 105–111.
- Pattimore, D., Ward, E., Thomas, P., and Bradford, M. (1991) The Nature and Cause of Lower Limb Injuries in Car Crashes. Proceedings of the 35th Stapp Car Crash Conference, pp. 177–187. Society of Automotive Engineers, Warrendale, PA.
- Petit, P., Portier, L., Foret-Bruno, J.Y., Trosseille, X., Parenteau, C., Coltat, J.C., Tarrière, C., and Lassau, J.P. (1996) Quasistatic Characterization of the Human Foot-Ankle Joints in a Simulated Tensed State and Updated Accidentological Data. Proceedings of the International Research Council on the Biomechanics of Impact, pp. 363–376.
- Petit, P., and Trosseille, X. (1999) Comparison of the THOR, HYBRID III and Cadaver Lower Leg Dynamic Responses in Dorsiflexion. Proceedings of the 43rd Stapp Car Crash Conference, pp. 161–169. Society of Automotive Engineers, Warrendale, PA.
- Pilkey, W.D., Sieveka, E.M., Crandall, J.R., and Klopp, G. (1994) The Influence of Foot Placement and Vehicular Intrusion on Occupant Lower Limb Injury in Full-Frontal and Frontal-Offset Crashes. Proceedings of the 14th International Technical Conference on the Enhanced Safety of Vehicles, pp. 734–741.
- Portier, L., Petit, P., Dômont, A., Trossielle, X., le Coz, J.Y., Tarrière, C., and Lassau, J.P. (1997) Dynamic Biomechanical Dorsiflexion Responses and Tolerances of the Ankle Joint Complex. Proceedings of the 41st Stapp Car Crash Conference, pp. 207–224. Society of Automotive Engineers, Warrendale, PA.
- Portier, L. (1999) Personal Communication.
- Rosner, B.A. (1995) Fundamentals of Biostatistics. Duxbury Press, Belmont.
- Rudd, R.W., Crandall, J.R., and Butcher, J.T. (1999) Biofidelity Evaluation of Dynamic and Static Response Characteristics of the THOR LX Dummy Lower Extremity. Proceedings of the International Research Council on the Biomechanics of Impact, pp. 485–497.
- Rudd, R.W., Crandall, J.R., and Shaw, G. (2003) Response of the Thor-Lx and Hybrid III Lower Extremities in Frontal Sled Tests. SAE International Congress and Exposition, paper no. 2003-01-0161. Society of Automotive Engineers, Warrendale, PA.
- Schwalbe, H.J., Bamfaste, G., and Franke, R.P. (1999) Non-destructive and Non-Invasive Observation of Friction and Wear of Human Joints and of Fracture Initiation by Acoustic Emission. Journal of Engineering in Medicine 213H: 41–48.
- Shams, T., Beach, D., White, R.P., Rangarajan, N., Haffner, M., Eppinger, R., Pritz, H., Kuppa, S., and Beebe, M. (1999) Development and Design of Thor-Lx: The Thor Lower Extremity. Proceedings of the 43rd Stapp Car Crash Conference, pp. 141–160. Society of Automotive Engineers, Warrendale, PA.
- Shaw, G., Rudd, R.W., Crandall, J.R., and Luo, F. (2002) Comparative Evaluation of Dummy Response with Thor-Lx/HIIIr and Hybrid III Lower Extremities. SAE International Congress and Exposition, paper no. 2002-10-0016. Society of Automotive Engineers, Warrendale, PA.
- Sherwood, C., O’Neill, B., and Hurwitz, S. (1999) Lower Extremity Injury Causation in Frontal Crashes. Proceedings of the International Research Council on the Biomechanics of Impact, pp. 513–524.
- States, J.D. (1986) Adult Occupant Injuries to the Lower Limb. In Biomechanics and Medical Aspects of Lower Limb Injuries. Society of Automotive Engineers, Warrendale, PA.
- Taylor, A., Morris, A., Thomas, P., and Wallace, A. (1997) Mechanisms of Lower Extremity Injuries to Front Seat Car Occupants – An In-depth Accident Analysis. Proceedings of the International Research Council on the Biomechanics of Impact, pp. 53–72.
- Thompson, R.C., Oegema, T.R., Lewis, J.L., and Wallace, L. (1991) Osteoarthritic Changes After Acute Transarticular Load. Journal of Bone and Joint Surgery 73A(7): 990–1001.
- Torzilli, P.A., Grigiene, R., Borrelli, J., and Helfet, D.L. (1999) Effect of Impact Load on Articular Cartilage: Cell Metabolism and Viability and Matrix Water Content. Journal of Biomechanical Engineering 121(5): 433–441.
- Wright, T.M., Arnoczky, S.O., and Burstein, A.H. (1979) In situ Monitoring of Ligament Damage in the Canine Knee by Acoustic Emission. Materials Evaluation 37: 47–58.
- Wright, T.M., Vosburgh, F., and Burstein, A.H. (1981) Permanent Deformation of Compact Bone Monitored by Acoustic Emission. Journal of Biomechanics 14(6): 405–409.