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Foot Ankle Int. 2006 Oct;27(10):793-6.

Revisiting the concept of talar shift in ankle fractures.

Author information

1
4 Victoria Drive West, Salisbury District Hospital, Wiltshire, SP2 8QX United Kingdom. jelloyd1@btopenworld.com

Abstract

BACKGROUND:

In 1976, Ramsey and Hamilton published a classic experiment investigating the biomechanical effects of talar shift in a simple ankle fracture model. Their finding was that 1 mm of talar shift resulted in a 42% decrease in tibiotalar contact surface area. Based on this conclusion, 1 mm of talar shift became the recognized indication for operative fixation.

METHODS:

Twelve cadaver ankles were dissected and the distal tibia coated with carbon powder. A 70-kg load was applied to the distal tibia that resulted in transference of the carbon onto the talus. The contact surface area was determined at 0, 1, 2, 4 and 6 mm of talar shift using spacers fixed in the medial gutter. Tracing paper was used to mark the outline of the contact area and measured using graph paper.

RESULTS:

Our results were similar to Ramsey and Hamilton's original experiment. One millimeter of lateral talar shift resulted in 40% loss of contact surface area compared with 42% in the original experiment. A large variance was seen in talar contact surface area depending on the morphology of the ankle joint.

CONCLUSION:

Ramsey and Hamilton's original experiment was valid.

PMID:
17054879
DOI:
10.1177/107110070602701006
[Indexed for MEDLINE]

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