三踝骨折术后患者不同步行状态时的足底压力特征  

Plantar Pressure Features under Different Walking Conditions in Patients after Trimalleolar Fracture Surgery

作　　者：朱婷 王雅 林金鹏 王文锦 仲荣洲[2] 翟华 王少白[1] ZHU Ting;WANG Ya;LIN Jinpeng;WANG Wenjin;ZHONG Rongzhou;ZHAI Hua;WANG Shaobai(School of Kinesiology,Shanghai University of Sport,Shanhai 200438,China;Shanghai Yangzhi Rehabilitation Hospital(Shanghai Sunshine Rehabilitation Center),Tongji University School of Medicine,Shanghai 201619,China)

机构地区：[1]上海体育学院运动科学学院,上海200438 [2]同济大学附属上海市养志康复医院(上海市阳光康复中心),上海201619

出　　处：《医用生物力学》2021年第4期625-632,共8页Journal of Medical Biomechanics

基　　金：科技部重点研发计划(2018YFF0300504);国家自然科学基金项目(81702211);上海市进一步加快中医药事业发展三年行动计划2018~2020年(ZY(2018-2020)-FWTX-8016);上海市残疾人康复科研项目(K2018024)。

摘　　要：目的比较三踝骨折术后患者不同步行状态下患侧和健侧足底压力特征,并与健康受试者进行对比。方法对12例三踝骨折术后恢复期患者和23例健康受试者不同步行状态的足底压力特征进行测试,包括足底10个区域峰值压强、接触面积、接触时间百分比。结果患侧与健侧对比:平地步行时患侧第3~5趾骨区域峰值压强小于健侧,患侧中足区域接触面积小于健侧;内翻斜面时,患侧第3~5趾骨区域峰值压强、接触面积小于健侧;外翻斜面时,患侧第3~5趾骨区域峰值压强、接触面积、接触时间百分比小于健侧,后足区域峰值压强显著大于健侧。患者与健康受试者对比:在3种步行状态下,患者第2、第3跖骨以及第2、第3~5趾骨区域峰值压强均小于正常者,患者第1、第2、第3~5趾骨区域接触面积均小于正常者,患者第2、第3~5趾骨接触时间百分比小于正常者,中足、后足接触时间百分比大于正常者。结论三踝骨折术后患者双侧足底压力特征存在不对称性。与正常者对比,患者在步行支撑相的足底压力异常。患者在外翻斜面运动控制能力、稳定性较正常者有所下降。外翻斜面的足底压力测试能够用于评估患者踝功能。Objective To analyze plantar pressure features of patients in injured and healthy sides of the lower limbs under different walking conditions after the trimalleolar fracture surgery,and compare these characteristics with healthy subjects.Methods Twelve Trimalleolar fracture patients and twenty-three healthy subjects were recruited and their plantar pressure characteristics under different walking conditions were tested,including peak pressure,contact area and contact time percentage.Results Comparison between injured and healthy sides:during level walking,peak pressure of the 3 rd-5 thtoe in the injured feet were smaller than those in the healthy sides;in inversion position,peak pressure and contact area of the 3 rd-5 thtoe area in the injured feet were smaller than those in the healthy side;in eversion position,peak pressure,contact area and contact time of the 3 rd-5 th toe in the injured feet were smaller than those in the healthy sides,and peak pressures of the hindfoot area were larger than those in the healthy sides.Comparison between patients and healthy subjects:under three kinds of walking conditions,peak pressures of the 2 ndand 3 rdmetatarsus bones,the 2 ndtoe,the 3 rd-5 thtoe,contact area of the 1 st-5 thtoe and contact time percentage of the 2 ndtoe,the 3 rd-5 thtoe area were all smaller than those of healthy subjects,while contact time of the hindfoot and mid-foot area were all smaller than those of healthy subjects.Conclusions The plantar pressure characteristics of Trimalleolar fracture patients were asymmetrical.Compared with healthy subjects,the plantar pressure features of patients were abnormal during stance phase.Compared with healthy subjects,the motor control ability and stability of patients in eversion positions were decreased.The plantar pressure characteristics at ankle eversion can be used to evaluate ankle joint function.

关 键 词：三踝骨折 足底压力 踝关节内翻 踝关节外翻 

分 类 号：R318.01[医药卫生—生物医学工程]