不同康复训练方法对术后拇外翻第1跖列的生物力学影响  

Effects of Different Rehabilitation Training Methods on the First Ray of Postoperative Hallux Valgus

作　　者：郭俊超 王丽珍[2] 常程[3,4] 温建民 樊瑜波[1,2] GUO Junchao;WANG Lizhen;CHANG Cheng;WEN Jianmin;FAN Yubo(Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability,Key Laboratory of Human Motion Analysis and Rehabilitation Technology of the Ministry of Civil Affairs,National Research Center for Rehabilitation Technical Aids,Beijing 100176,China;Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education,School of Biological Science and Medical Engineering,Beihang University,Bering 100191,China;Department of Orthopedic Surgery,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China;Clinical College of Chinese Medicine,Shanxi University of Chinese Medicine,Taiyuan 030619,China)

机构地区：[1]国家康复辅具研究中心、北京市老年功能障碍康复辅助技术重点实验室、民政部人体运动分析与康复技术重点实验室,北京100176 [2]北京航空航天大学生物与医学工程学院、生物力学与力生物学教育部重点实验室,北京100191 [3]中国中医科学院望京医院矫形外科,北京100102 [4]山西中医药大学中医临床学院,太原030619

出　　处：《医用生物力学》2018年第5期453-458,共6页Journal of Medical Biomechanics

基　　金：国家自然科学基金项目(11572029,11702068,11120101001,11602063);民政部基本科研项目(118009001000160001)

摘　　要：目的研究拇外翻术后不同康复训练对第1跖列的生物力学影响。方法通过拇外翻医学影像数据建立完整的足部三维有限元模型,此模型包括骨骼、籽骨、软骨、韧带、软组织、跟腱等结构。模拟分析拇外翻患者术后被动跖屈和背屈、主动跖屈和背屈、站立位对截骨远端的生物力学影响。结果被动训练情况下,截骨远端截骨面的应力分布较均匀,且峰值（7. 78 MPa）较站立位和主动训练时大;被动训练时的最大位移量（0. 98 mm）在前后方向上大于站立位（0. 69 mm）和主动训练（0. 38 mm）的位移量。结论被动训练可促进截骨面的接触,并减少截骨端的愈合时间,有利于术后拇外翻患者的康复。Objective To investigate the effect of the different rehabilitation training method on the first ray of postoperative hallux valgus（ HV）. Methods Based on medical images of HV patient,a comprehensive three-dimensional finite element model of HV foot was established,including bones,sesamoid,cartilage,ligaments,soft tissues,Achilles tendon. The passive/active plantar flexion and dorsal flexion as well as standing were simulated to investigate the biomechanical behavior of distal osteotomy fragment of the postoperative HV. Results The stress distribution on distal osteotomy fragment during passive training was more uniform, and the peak stress（ 7. 78 MPa） was greater than that during stance phase and active training. The distal osteotomy fragment displacement during passive training（ 0. 98 mm） in anterior-posterior direction was greater than that during stance phase（ 0. 69 mm） and active training（ 0. 38 mm）. Conclusions The passive training could promote the contact of osteotomy surface and reduce the healing time of osteotomy,which would be beneficial for rehabilitation of postoperative HV.

关 键 词：拇外翻 康复训练 截骨远端 应力 位移 

分 类 号：R318.01[医药卫生—生物医学工程]