踝关节内侧韧带损伤肌腱重建的三维有限元分析  

Three-dimensional finite element analysis of tendon reconstruction in ankle with deltoid ligament injury

作　　者：许灿[1] 张明彦[1] 雷光华[1] 文霆[1] 何洪波[1] 章灿[1] 李康华[1] 

机构地区：[1]中南大学附属湘雅医院,湖南省长沙市410008

出　　处：《中国组织工程研究》2012年第35期6478-6483,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:踝关节内侧三角韧带损伤的重建方法很多,但是目前还没有研究对这些方法进行对比。目的:三维有限元法对比Wiltberger、Deland、Kitaoka和Hintermann4种修复方法重建踝关节内侧韧带损伤肌腱后的效果。方法:建立踝关节三维有限元模型,模型中包括踝周的6块骨性结构、软骨和主要韧带。对模型进行验证试验后,在其基础上建立三角韧带损伤、Wiltberger、Deland、Kitaoka和Hintermann重建模型。在踝关节不同屈曲角度上对模型施加外翻及外旋应力,比较重建后的踝关节生物力学。结果与结论:4种重建方法均不能使踝关节生物力学完全恢复正常,其中Kitaoka法在恢复踝关节外旋稳定性上最有效,Deland法在恢复踝关节外翻稳定性上最有效。提示4种内侧韧带肌腱重建术式中,Kitaoka和Deland法较其他方法能够相对有效的恢复踝关节旋转稳定性。BACKGROUND： There are many methods to reconstruct the ankle with deltoid ligament injury, but there is no study to compare these methods. OBJECTIVE： To compare the effect of Wiltberger, Deland, Kitaoka and Hintermann on the repair of ankle with deltoid ligament injury by three-dimensional finite element analysis. METHODS： A three-dimensional finite element model of the ankle included six bony structures, cartilage and principal ligaments. In addition to the intact model, superficial deltoid-deficient, Wiltberger reconstruction, Deland reconstruction, Kitaoka reconstruction and Hintermann reconstruction models were simulated. Then, the biomechanics of the ankle joint was evaluated by loading the eversional or external torque through the range of ankle flexion. RESULTS AND CONCLUSION： No reconstruction method could completely restore the values for ankle flexibility and the stresses of the lateral ligaments to normality. The Kitaoka procedure was the most effective technique in eliminating external rotation displacement. The Deland procedure was the most effective technique in restoring the alar tilt stability. Among the four deltoid ligament reconstruction techniques, Kitaoka and Deland procedures have the advantage in restoring the stability of ankle rotation.

关 键 词：踝关节 三角韧带 有限元 生物力学 肌腱重建 

分 类 号：R318[医药卫生—生物医学工程]