Chevron截骨术对母外翻足关节接触特征影响的生物力学研究

doi:10.13418/j.issn.1001-165x.2023.1.15

中国临床解剖学杂志 ›› 2023, Vol. 41 ›› Issue (1): 81-86.doi: 10.13418/j.issn.1001-165x.2023.1.15

Chevron截骨术对母外翻足关节接触特征影响的生物力学研究

马冬¹，王镱凝¹, 徐楚江²，肖进³，冯正宽¹，许广威¹，于宛琪¹，钱蕾¹*，欧阳钧¹*

1.南方医科大学基础医学院人体解剖学教研室，广东省数字医学与生物力学重点实验室，广州 510515；
2.南方医科大学中西医结合医院骨科，广州 510315； 3.广东省人民医院骨科，广州 510000

收稿日期:2022-09-26 出版日期:2023-01-25 发布日期:2023-02-08
通讯作者: 钱蕾，讲师，E-mail：dorisql712@126.com；欧阳钧，教授，博士生导师，E-mail：jouyang@126.com
作者简介:马冬（1996-），女，河北秦皇岛人，硕士，主要从事肌骨关节生物力学与运动生物力学方面的研究，E-mail：738869783@qq.com
基金资助:
国家自然科学基金青年基金（32101054）；广东省自然科学基金面上项目（2021A1515010877）

Biomechanical effect of the distal Chevron osteotomy on contact characteristics of foot joints of hallux valgus

Ma Dong¹, Wang Yining¹, Xu Chujiang², Xiao Jin³, Feng Zhengkuan¹, Xu Guangwei¹, Yu Wanqi¹, Qian Lei¹*, Ouyang Jun¹*

1.Department of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, Guangzhou 510515, China; 2. Department of Orthopedics, TCM-Integrated Hospital of Southern Medical University, Guangzhou 510515, China; 3. Department of Orthopedics, Guangdong Provincial People’s Hospital, Guangzhou 510000, China

Received:2022-09-26 Online:2023-01-25 Published:2023-02-08

摘要/Abstract

摘要： 目的探究Chevron截骨术截骨远端外侧位移距离对母外翻足关节接触特征的影响，为临床上选择合适的位移距离提供参考依据。方法测量踝关节中立位状态下正常足、母外翻足及母外翻足Chevron截骨术截骨远端分别向外侧位移2.0、4.0、6.0 mm后前足、中足和后足各关节接触力、峰值压强和接触面积，并对结果进行分析。结果与正常足相比，母外翻足第1跖楔关节（t=-3.33, P=0.02）、跟骰关节（t=-2.74, P=0.03）和距下关节（后关节面）（t=-2.89, P=0.03）的接触力显著增高；母外翻足距舟关节（t=-2.73, P=0.03）与跟骰关节（t=-2.74, P=0.03）的峰值压强显著增高；行Chevron截骨术后，随着截骨远端向外侧位移距离的增加，母外翻足第1跖楔关节和跟骰关节的接触力逐渐减小；母外翻足距舟关节和跟骰关节的峰值压强逐渐减小。结论中度母外翻足行Chevron截骨术后，当第1跖骨截骨远端向外侧位移6 mm时能有效恢复部分关节间力的分布，且能缓解部分关节局部应力集中现象。

关键词: 母外翻； , , Chevron截骨术； , , 接触力； , , 峰值压强； , , 接触面积

Abstract: Objective To explore the influence of the distal lateral displacement distance of Chevron osteotomy on contact characteristics of the hallux valgus, so as to provide reference for selecting suitable displacement distance in clinical practice. Methods The contact force, peak pressure and contact area of each joint of the forefoot, midfoot and hindfoot were measured in normal foot, hallux valgus foot, the distal Chevron osteotomy of the hallux valgus after the lateral displacement of 2.0, 4.0, 6.0 mm in the neutral position of the ankle joint, respectively. The results were compared and analyzed. Results Compared with the normal foot, the contact force of the 1st tarsometatarsal joint (t=-3.33, P=0.02), the calcaneocuboid joint (t=-2.74, P=0.03) and the subtalar joint (posterior articular surface) (t=-2.89, P=0.03) of hallux valgus foot significantly increased. The peak pressure of the talonavicular joint (t=-2.73, P=0.03) and the calcaneocuboid joint (t=-2.74, P=0.03) of the hallux valgus foot increased significantly. After Chevron osteotomy was performed, with the increasing of lateral displacement distance of distal osteotomy, the contact force of the 1st tarsometatarsal joint and the calcaneocuboid joint of hallux valgus foot decreased gradually; the peak pressure of the the talonavicular joint and the calcaneocuboid joint of hallux valgus decreased gradually. Conclusions After Chevron osteotomy is performed on moderate hallux valgus foot, when the distal end of the first metatarsal osteotomy is displaced outward by 4mm or 6mm, it can effectively restore the distribution of some inter articular forces and alleviate the local stress concentration of some joints.

Key words: Hallux valgus; , , Chevron osteotomy; , , Contact force; , , Peak pressure; , , Contact area

中图分类号:

R318.01

马冬, 王镱凝, 徐楚江, 肖进, 冯正宽, 许广威, 于宛琪, 钱蕾, 欧阳钧. Chevron截骨术对母外翻足关节接触特征影响的生物力学研究[J]. 中国临床解剖学杂志, 2023, 41(1): 81-86.

Ma Dong, Wang Yining, Xu Chujiang, Xiao Jin, Feng Zhengkuan, Xu Guangwei, Yu Wanqi, Qian Lei, Ouyang Jun. Biomechanical effect of the distal Chevron osteotomy on contact characteristics of foot joints of hallux valgus[J]. Chinese Journal of Clinical Anatomy, 2023, 41(1): 81-86.

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Chevron截骨术对母外翻足关节接触特征影响的生物力学研究

Biomechanical effect of the distal Chevron osteotomy on contact characteristics of foot joints of hallux valgus

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