Axial loading of the foot/ankle complex is an important injury mechanism in vehicular trauma that is responsible for severe injuries such as calcaneal and tibia pilon fractures. Axial loading may be applied to the leg externally, by the toepan and/or pedals, as well as internally, by active muscle tension applied through the Achilles tendon during pre-impact bracing. In order to evaluate the effect of active muscle tension on the injury tolerance of the foot/ankle complex, blunt axial impact tests were performed on 44 isolated lower legs with and without experimentally simulated Achilles tension. The primary fracture mode was calcaneal fracture in both groups, but tibia pilon fractures occurred more frequently with the addition of Achilles tension. Acoustic emission demonstrated that fracture initiated at the time of peak local axial force. A survival analysis was performed on the injury data set using a Weibull regression model with specimen age, gender, body mass, and peak Achilles tension as predictor variables. A closed-form solution was developed to predict the risk of fracture to the foot/ankle complex in terms of axial tibia force. Several potential injury assessment reference values are presented for different ages, body types, and injury risks.
Samenvatting