第1跖骨颈部微创截骨联合分趾垫和“8”字绷带外固定治疗拇外翻的有限元分析  

Finite element analysis of mini-invasive osteotomy in the first metatarsal neck combined with hallux valgus splint and figure-of-eight bandage fixation in the treatment of hallux valgus

作　　者：孙卫东 胡海威[1] 温建民[1] 桑志成[1] 吴寿长[1] 成永忠[1] 余志勇 王庆雷[3] 

机构地区：[1]中国中医科学院望京医院,北京100102 [2]湖北省襄阳市中医医院,湖北襄阳441000 [3]北京市老年病医院,北京100095

出　　处：《中医正骨》2014年第4期3-6,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：国家自然科学基金项目(30772815;81273984)

摘　　要：目的:探讨拇外翻患者采用第1跖骨颈部微创截骨联合分趾垫和"8"字绷带外固定治疗后截骨端的稳定性和截骨愈合的生物力学机制。方法:选取1位青年女性拇外翻患者,年龄28岁,身高168 cm,体质量62 kg,右足拇外翻角24°,第1、2跖骨间角13°。利用其右足CT扫描所获得的数据建立右足拇外翻骨骼有限元模型,并模拟第1跖骨颈部微创截骨联合分趾垫和"8"字绷带外固定术,测定截骨端的Von Mises应力和位移。结果:截骨端X轴位移为0.261 mm,Y轴位移为0.078 mm,Z轴位移为-0.167 mm,截骨端总位移为0.293 mm;截骨端Von Mises应力为0.712 MPa,主要分布在截骨端的外侧边缘部位。结论:采用第1跖骨颈部微创截骨联合分趾垫和"8"字绷带外固定治疗拇外翻,截骨端之间位移小、应力适中,能使截骨端以软骨成骨的方式愈合。Objective： To study the stability of the end of the cut bone and the biomechanical mechanism of cut bone healing in the patients with hallux valgus treated with mini- invasive osteotomy in the first metatarsal neck combined with hallux valgus splint and figure-of- eight bandage fixation. Methods： One female with hallux valgus（ age 28 years,height 168 cm,body mass 62 kg） was selected. Her right hallux valgus angle was 24 degree and her intermetatarsal angle was 13 degree. The finite element model of right foot hallux valgus was built by using CT data,and the Von Mises stress and displacement were measured after simulating mini- invasive osteotomy in the first metatarsal neck combined with hallux valgus splint and figure- of- eight bandage fixation. Results： The displacement in X- axis was 0. 261 mm, the displacement in Y- axis was 0. 078 mm,the displacement in Z- axis was- 0. 167 mm,and the total displacement was 0. 293 mm. The Von Mises stress was 0. 712 Mpa and was mainly distributed at the lateral margin of the end of the cut bone. Conclusion： In the treatment of hallux valgus,the therapy of mini- invasive osteotomy in the first metatarsal neck combined with hallux valgus splint and figure- of-eight bandage fixation has such advantages as small displacement,moderate stress,furthermore,the end of the cut bone can be united by means of os cartilaginea.

关 键 词：拇外翻 截骨术 有限元分析 

分 类 号：R658.2[医药卫生—外科学]