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Talus Morphology and Its Functional Implications on the Ankle Joint

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Talus Morphology and Its Functional Implications on the Ankle Joint Talus morphology and its functional implications on the ankle joint A Thesis Submitted to the Faculty of Drexel University by Damani .Y. Seale in partial fulfillment of the requirements for the degree of Master of Science in Mechanical Engineering and Mechanics June 2011 ii Acknowledgements Thank you to my parents and siblings for your constant support and your continued implicit confidence in me and my abilities. To my parents, your accomplishments, despite the challenges you faced greatly inspire me and are the source for my own confidence in myself and my abilities. Thank you to my advisor and mentor Dr. Sorin Siegler for the opportunity to work with you and learn from you over the past couple years. The opportunities you have provided me and your guidance throughout my time at the biomechanics lab have greatly improved my analytical and engineering skills. Thank you to Dr. Jason Toy for your contributions to this work. Thank you to the teachers and staff of Queen’s Royal College for your efforts which were largely responsible for my development. Thank you to my friends for your support during this and every time. May we never change unless we choose to. Dedicated to Safi and Kani. iii Table of Contents List of Figures ............................................................................................................................................... iv List of Tables ................................................................................................................................................ iv Abstract ........................................................................................................................................................ vi Chapter 1: Introduction ................................................................................................................................ 1 1.1 Specific Aims ....................................................................................................................................... 1 1.2 Background and Significance .............................................................................................................. 2 1.2.1 Osteology ..................................................................................................................................... 2 1.2.2 Syndesmology ............................................................................................................................ 10 1.2.3 Mechanics of the Ankle joint ..................................................................................................... 11 1.2.4 Limitations of Previous Studies .................................................................................................. 16 Chapter 2: Methods .................................................................................................................................... 17 2.1 Image Processing .............................................................................................................................. 17 2.2 Morphological Measurements .......................................................................................................... 19 2.3 Anatomical Axes ................................................................................................................................ 22 2.3.1 Intermalleolar axis ..................................................................................................................... 22 2.3.2 Trochlear cone axis .................................................................................................................... 24 2.4 Anatomical Reference Planes ........................................................................................................... 25 2.5 Anatomical Axes Orientation ............................................................................................................ 30 2.6 Cone Skewness .................................................................................................................................. 32 Chapter 3: Results ....................................................................................................................................... 34 3.1 Morphological measurements of Talus ............................................................................................ 35 3.2 Anatomical Axis Orientation ............................................................................................................. 37 3.3 Square of Direction Cosines .............................................................................................................. 39 3.4 Cone Skewness .................................................................................................................................. 41 Chapter 4: Discussion .................................................................................................................................. 43 4.1 Trochlear Cone .................................................................................................................................. 43 4.2 Axis of Rotation ................................................................................................................................. 44 List of References ........................................................................................................................................ 49 iv List of Tables Table 1: Morpological Measurements of Talus .......................................................................................... 35 Table 2 Angles between intermalleolar axis, trochlear cone axis and reference axes ............................... 37 Table 3 Square of Direction Cosines. .......................................................................................................... 39 Table 4 Trochlear Cone Skweness. .............................................................................................................. 41 v List of Figures Figure 1: Distal Fibula .................................................................................................................................... 2 Figure 2: Distal Tibia ...................................................................................................................................... 4 Figure 3: Tibial Plafond Conical Angle ........................................................................................................... 5 Figure 4: Talus ‐ General Features ................................................................................................................ 7 Figure 5: Talus ‐ Trochlear Surface Apical Angle Variation ........................................................................... 8 Figure 6: Trochlear Surface approximation as frustum of cone ................................................................... 9 Figure 7: Anterior Talofibular Ligament ...................................................................................................... 10 Figure 8: Single axis of motion of the ankle joint . ...................................................................................... 12 Figure 9: Multiple axes of rotation of the ankle joint . ............................................................................... 14 Figure 10: Thresholding process in Analyze 8.1. ......................................................................................... 18 Figure 11: 3D volumetric talus model. ........................................................................................................ 20 Figure 12: Creation of the medial and lateral best fit circles. ..................................................................... 21 Figure 13: Intermalleolar axis ..................................................................................................................... 23 Figure 14: Trochlear cone axis .................................................................................................................... 24 Figure 15: Coronal plane construction ........................................................................................................ 26 Figure 16: Transverse plane construction ................................................................................................... 27 Figure 17: Anatomical Reference planes .................................................................................................... 28 Figure 18: Anatomical Reference axes. ....................................................................................................... 29 Figure 19: Measurement of angle between intermalleolar axis and anatomical reference axis 1. ........... 31 Figure 20: Skewness of trochlear cones...................................................................................................... 33 vi Abstract Talus morphology and its functional implications on the ankle joint Damani Seale Sorin Siegler, PhD. A clear understanding of the ankle joint has applications from the design of ankle braces to the design of ankle implants and total ankle replacements. Examination of the articular trochlear surface of the talus can be used to describe talar morphology and explain ankle joint kinematics. A testing protocol was established to determine which of two anatomical axes; intermalleolar axis and trochlear cone axis; best approximates the axis of rotation of the ankle joint. Anatomical axes were located and oriented using anatomical landmarks obtained from CT images for the foot and ankle.
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