跖腱膜对前足静力性维持的生物力学分析  

Static support of the plantar fascia to the forefoot

作　　者：闵晓晖[1] 杨云峰[1] 俞光荣[1] 朱辉[1] 周家钤[1] 袁锋[1] 王明鑫[1] 丁祖泉[1] 

机构地区：[1]同济大学附属同济医院骨科,上海市普陀区新村路389号200065

出　　处：《中国矫形外科杂志》2009年第6期446-450,共5页Orthopedic Journal of China

基　　金：国家自然科学基金资助项目(编号:30640058;30801163)

摘　　要：[目的]测量跖腱膜和足底其它韧带损伤前后前足的形态和足底压力改变,分析跖腱膜对前足的力学维持。[方法]7例正常成人新鲜尸体足标本,解剖显露足底跖筋膜、弹簧韧带、跖长韧带、跖短韧带。经电子万能试验机逐级加载至700 N,利用数字散斑相关法测量足底韧带损伤前后跖骨头位移的变化情况,通过F-scan足底压力测量系统测量前足压力分布,对结果进行统计分析。[结果]跖腱膜损伤后,前足各跖骨冠状面水平位移同损伤前相比较差异无统计学意义(P1>0.05);矢状面纵向位移除M1外其余跖骨位移变化无统计学意义(P1>0.05):M1、M2下峰值压力变化无统计学意义(P1>0.05),M3～M5下峰值压力变化有统计学意义(P1<0.05)。4条韧带损伤后,各跖骨纵向位移、横向位移及跖骨头下压力峰值同韧带损伤前及单纯跖腱膜损伤相比较差异有统计学意义(P2<0.05)。[结论]跖腱膜松解不会造成足弓整体结构的塌陷,但将引起足部力学环境的改变,导致足部其他韧带结构的疲劳或损伤,出现远期并发症。[ Objective ] To explore displacement and plantar pressure distribution of the forefoot before and after the plantar fascia and other plantar ligaments were sectioned. [ Method ] Seven fresh adult cadaveric feet were tested with the main plantar ligaments exposed, including the plantar fascia, spring ligament, short plantar ligament and long plantar ligament. The displacements of the metatarsals were recorded and calculated with digital speckle correlation measurement （ DSCM ）, also F - scan insoles were put under the plantar aspect of the feet when the speciments were loaded to 700N vertically. The special shifts and plantar pressure data of the metatarsals was collected and stored before and after the main plantar ligaments were sectioned. [ Result ] The transverse movements of the metatarsals did not change significantly, the same as their vertical displacements except the first metatarsal after the plantar fascia was sectioned ,while the peak pressure shifted laterally. When the four major plantar ligaments were all injured, all of the above changed significantly. [ Conclusion] The plantar fasciotomy will not consequentially lead to collapse of the forefoot structure. But the redistribution of the plantar pressure and the compensation of other ligaments may result in later complication.

关 键 词：足损伤 韧带 数字散斑相关测量 生物力学 跖骨 

分 类 号：R686[医药卫生—骨科学] R318.01[医药卫生—外科学]