Ankle injuries are a common musculoskeletal affliction. One mode of ankle injury is due to extreme dorsiflexion. This phase of the ankle injury project addresses injuries to ankles involving dorsiflexion, in particular at high rates of loading such as might occur in automotive accidents. High rates of axial compression loading were also investigated. The types of injuries include malleolar fractures and ligament avulsions and ruptures.
Twelve pair of cadaver and two Hybrid III lower limbs were loaded on the bottom of the foot via a pneumatic cylinder. The rate of loading varied from pseudostatic to 7 m/s in dorsiflexion mode and in axial tests the load was applied for 50, 100 or 500 ms with a rate of loading of approximately 500 kN/sec. Standard range of motion tests were done before and after testing. Human volunteers were tested for maximum voluntary dorsiflexion in a separate fixture which recorded torque and dorsiflexion angle.
Dorsiflexion angles up to 80 degrees were recorded with injuries occurring between 35 and 59 degrees of dorsiflexion angle. Injuries were observed occurring from high speed films of the denuded ankle joint. Moment at the ankle joint of up to 200 Nm were calculated with injuries occurring at between 40 to l00 Nm. Angular deflection appears to be the best predictor of injury. Cadavers were able to sustain axial loads up to 7500 N for 100 ms without injury. Loads sufficient to cause injury in axial loading were not attained. Relaxed volunteers were Well able to tolerate 30 N m torque on the ankle joint at angles up to 45 degrees.
|1990||Begeman PC, Prasad P. Human ankle impact response in dorsiflexion. In: Proceedings of the 34th Stapp Car Crash Conference. November 4-7, 1990; Orlando, FL. Warrendale, PA: Society of Automotive Engineers:39-53. SAE 902308.|
|1990||The Abbreviated Injury Scale-1990 Revision. Des Plaines, IL: Association for the Advancement of Automotive Medicine (AAAM); 1990.|
|1965||Hirsch C, Lewis J. Experimental ankle-joint fractures. Acta Orthop Scand. 1965;36(4):408-417.|
|1991||Pattimore D, Ward E, Thomas P, Bradford M. The nature and cause of lower limb injuries in car crashes. In: Proceedings of the 35th Stapp Car Crash Conference. November 18-20, 1991; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:177-188. SAE 912901.|
|1991||Morgan RM, Eppinger RH, Hennessey BC. Ankle joint injury mechanism for adults in frontal automotive impact. In: Proceedings of the 35th Stapp Car Crash Conference. November 18-20, 1991; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:189-198. SAE 912902.|
|1995||Beaugonin M, Haug E, Munck G, Cesari D. A preliminary numerical model of the human ankle under impact loading. International Conference on Pelvic and Lower Extremity Injuries Proceedings; 1995.277-289.|
|1994||Crandall JR, Klisch SM, Klopp GS, Sieveka E, Pilkey WD, Martin P. Research program to investigate lower extremity injuries. In: Proceedings of the SAE International Congress & Exposition. February 28–March 3, 1994; Detroit, MI. Warrendale, PA: Society of Automotive Engineers:19-30. SAE 940711.|
|2004||Haug E, Choi H-Y, Robin S, Beaugonin M. Human models for crash and impact simulation. In: Ayache N, ed. Computational Models for the Human Body. Amsterdam, The Netherlands: Elsevier B.V; 2004:231-452. Ciarlet PG, ed. Handbook of Numerical Analysis; vol 12.|
|2015||Salzar RS, Lievers WB, Bailey AM, Crandall JR. Leg, foot, and ankle injury biomechanics. In: Yoganandan N, Nahum AM, Melvin JW, eds. Accidental Injury: Biomechanics and Prevention. 3rd ed. New York: Springer; 2015:499-547.|
|1995||Parenteau CS, Viano DC, Lovsund P, Tingvall C. Foot-ankle injuries: influence of crash location, seating position and age. In: 39th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 16-18, 1995; Chicago, IL.177-192.|
|2000||Funk JR, Tourret LJ, George SE, Crandall JR. The role of axial loading in malleolar fractures. In: Proceedings of the SAE World Congress. March 6-9, 2000; Detroit, MI. Warrendale, PA: Society of Automotive Engineers. SAE 2000-01-0155.|
|2002||Funk JR, Rudd RW, Srinivasan SCM, King RJ, Crandall JR, Petit PY. Methodology for measuring tibial and fibular loads in a cadaver. In: Proceedings of the SAE World Congress & Exhibition. 2002; Detroit, MI. Warrendale, PA: Society of Automotive Engineers. SAE 2002-01-0682.|
|1993||Begeman P, Balakrishnan P, Levine R, King A. Dynamic human ankle response to inversion and eversion. In: Proceedings of the 37th Stapp Car Crash Conference. November 7-8, 1993; San Antonio, TX. Warrendale, PA: Society of Automotive Engineers:83-93. SAE 933115.|
|1996||Crandall JR, Portier L, Petit P, Hall GW, Bass CR, Klopp GS, Hurwitz S, Pilkey WD, Trosseille X, Tarrière C, Lassau J-P. Biomechanical response and physical properties of the leg, foot, and ankle. In: Proceedings of the 40th Stapp Car Crash Conference. November 4-6, 1996; Albuquerque, NM. Warrendale, PA: Society of Automotive Engineers:173-192. SAE 962424.|
|1999||Petit P, Trosseille X. Comparison of the THOR, HYBRID III and cadaver lower leg dynamic responses in dorsiflexion. In: Proceedings of the 43rd Stapp Car Crash Conference. October 25-27, 1999; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:161-169. SAE 99SC10.|
|2001||Beillas P, Begeman PC, Yang KH, King AI, Arnoux P-J, Kang H-S, Kayvantash K, Brunet C, Cavallero C, Prasad P. Lower limb: advanced FE model and new experimental data. Stapp Car Crash J. 2001;45:469-494. SAE 2001-22-0022.|
|2011||Funk JR. Ankle injury mechanisms: lessons learned from cadaveric studies. Clin Anat. April 2011;24(3):350-361.|
|1998||Hall GW. Biomechanical Characterization and Multibody Modeling of the Human Lower Extremity [PhD thesis]. Charlottesville, VA: University of Virginia; May 1998.|
|2005||Rudd RW. Injury Tolerance of the Human Ankle in Impact-Induced Dorsiflexion [PhD thesis]. Charlottesville, VA: University of Virginia; January 2005.|
|2008||Kerrigan JR. A Computationally Efficient Mathematical Model of the Pedestrian Lower Extremity [PhD thesis]. Charlottesville, VA: University of Virginia; January 2008.|