踝关节融合术后后足关节生物力学分析  

Biomechanical analysis of hindfoot joint after ankle arthrodesis

作　　者：林文杰 孙欣 黄文华 魏波[1] 林涛 梁振明 钟环 张欣 欧阳汉斌 Lin Wenjie;Sun Xin;Huang Wenhua;Wei Bo;Lin Tao;Liang Zhenming;Zhong Huan;ZhangXin;Ouyang Hanbin(Department of Orthopedics Center,The Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,China;Guangdong Engineering Research Center for Translation of Medical 3D Printing Application,Guangdong Provincial Key Laboratory of Medical Biomechanics,National Key Discipline of Human Anatomy,School of Basic Medical Sciences,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]广东医科大学附属医院骨科中心,广东湛江524001 [2]南方医科大学基础医学院人体解剖学国家重点学科,广东省医学生物力学重点实验室,广东省医学3D打印应用转化工程技术研究中心,广州510515

出　　处：《中国临床解剖学杂志》2023年第2期212-217,共6页Chinese Journal of Clinical Anatomy

基　　金：广东省医学科研基金项目(B2021213);广东省科技计划项目(2018B090944002);湛江市科技发展专项资金竞争性分配项目(2020A01025);广东医科大学大学生创新实验项目(FYZY001)。

摘　　要：目的探讨踝关节融合术后后足关节的生物力学特性。方法利用健康成年男性志愿者右踝关节CT图像,构建踝关节融合前的三维有限元模型,在此基础上模拟踝关节融合术后骨性融合状态,采用中立、外旋、内旋、背伸和跖屈的5种载荷工况分别对融合前、后模型组进行有限元分析,评估踝关节融合前后的整体刚度变化、距下关节和距舟关节的接触力学特性变化。结果踝关节发生骨性融合后,整体结构刚度较融合前模型显著增高;除中立位工况以外,融合后的距下关节的接触面积均有所减少,距舟关节接触面积则有所增加;而融合后的距下和距舟关节的接触应力在各工况下总体呈降低趋势。结论踝关节骨性融合术后相邻关节的接触特性改变可能是足部整体结构刚度提高后承载模式发生变化的结果,其与相邻后足关节退行性改变之间的关联尚有待进一步研究证实。Objective To investigate the biomechanical characteristics of hindfoot joint after ankle arthrodesis.Methods Based on the CT images of the right ankle of healthy adult male volunteers,a threedimensional finite element model of the normal ankle was constructed.On this basis,the bony fusion after ankle arthrodesis was simulated.Five load cases of neutral,external rotation,internal rotation,dorsiflexion,and plantar flexion were used to analyze the model group before and after fusion,and to evaluate the changes of overall stiffness and the contact mechanical characteristics of subtalar joint and talonavicular joint before and after ankle arthrodesis.Results After ankle arthrodesis,the overall structural stiffness was significantly higher than that of the model before fusion.Except for neutral condition,the contact area of subtalar joint after fusion decreased,while the contact area of talonavicular joint increased.The contact stress of subtalar joint and talonavicular joint after fusion generally showed a downward trend under various working conditions.Conclusions The change of contact characteristics of adjacent joints after ankle arthrodesis may be the result of the change of bearing mode after the improvement of the overall structural stiffness of the foot,and its association with the degenerative changes of adjacent hindfoot joints needs to be confirmed by further research.

关 键 词：踝关节创伤性关节炎 踝关节融合术 后足关节 有限元分析 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程] R687[医药卫生—基础医学]