Biomechanical analysis of contact pressure generated by the calcaneofibular ligament against the peroneus brevis tendon: A cadaveric study.

Abstract

A recent cadaveric study revealed that the tensed calcaneofibular ligament (CFL) lifts the peroneal tendons. This suggests that the CFL acts as a tensioner to transmit the contractile activity of the peroneal muscles effectively. However, the onset points of the lift-up and actual CFL-generated contact pressures against the peroneus brevis tendon (PBT) remain unclear. This cadaveric study aimed to elucidate the lift-up phenomenon through the quantitative measurement of changes in the contact pressure between the CFL and PBT under precise monitoring of the ankle position. We performed a quantitative analysis of 11 cadaveric ankle specimens with a pressure-sensitive sensor under accurate three-axial joint angle monitoring using inertial measurement units. The output values from the pressure-sensitive sensor inserted between the CFL and PBT were measured at different inversion (INV) angles, converted into contact pressure values (mV), and statistically analysed. Although the onset points differed across the samples, the contact pressure values of all samples showed a positive change as the INV angle increased. Friedman and post hoc Steel-Dwass tests revealed significant differences between INV 0° versus 10° (<i>p</i> < 0.01), 0° versus 15° (<i>p</i> < 0.001), 5° versus 10° (<i>p</i> < 0.05), 5° versus 15° (<i>p</i> < 0.001), and 10° versus 15° (<i>p</i> < 0.05). In addition, the sensor output values indicated an intraclass correlation coefficient (1, 1) of 0.90. Our findings strongly suggest that INV enhances the tensioner effect of CFL. Specifically, an ankle with a relatively early onset point and high contact pressure may exhibit a superior tensioner effect and, through the control of peroneal tendons, potentially prevent an ankle sprain. Not applicable.