The effect of posterior tibial tendon dysfunction on hindfoot kinematics
The effect of posterior tibial tendon dysfunction on hindfoot kinematics
复制标题
DOI：
10.1177/107110070102200404
复制
发表时间：
2001-04-01
影响因子：
2.7
通讯作者：
Sangeorzan, BJ
中科院分区：
文献类型：
--
作者：
Niki, H;Ching, RP;Sangeorzan, BJ
这项生物力学研究调查了胫骨后[肌腱(PTT)]在获得性平足力学中的功能作用。获得性扁平足畸形被归因于PTT功能障碍；然而，从急性功能障碍到终末期畸形的进展还没有完全证明。对8具人体小腿和足部标本进行了两个阶段的实验测试。在第一阶段，完整的(正常)样本被加载以模拟(A)脚跟着地、(B)站立和(C)脚跟抬高，包括有和没有PTT功能。然后，每个标本都接受了一种设计成模拟扁平足畸形的程序。在第二阶段中使用所得到的扁平足来检验恢复扁平足模型PTT功能的效果。在两个测试阶段，记录了后足复合体的三维运动方向。在第一阶段和第二阶段测试中，比较功能PTT和功能障碍PTT的效果时，观察到后足复合体角度方向的微小但有统计学意义的变化。最大的角度变化是在脚跟抬高时记录的。对于正常足，在PTT负荷释放后观察到的后足复合体方向的微小变化表明，在急性PTT功能障碍后，后足完整的骨-韧带结构最初能够维持正常的对齐。一旦软组织被削弱，就像我们的扁平足模型一样，PTT在克服软组织松弛以纠正足部位置方面效果甚微。
This biomechanical study investigated the functional role of the posterior tibia[ tendon (PTT) in acquired flatfoot mechanics. Acquired flatfoot deformity has been attributed to PTT dysfunction; however, the progression from acute dysfunction to end-stage deformity has not been fully demonstrated. Eight human cadaver lower leg and foot specimens were used in two phases of experimental testing. In Phase 1, intact (normal) specimens were loaded to simulate (a) heel strike, (b) stance, and (c) heel rise both with and without PTT function. Then, each specimen was subjected to a procedure designed to create a simulated flatfoot deformity. The resulting flattened feet were used in Phase 2 to examine the effect of restoring PTT function to a flatfoot model. During both phases of testing, the 3-D kinematic orientation of the hindfoot complex was recorded.Small but statistically significant changes in the angular orientation of the hindfoot complex were observed, during both Phase 1 and 2 testing, when comparing the effects of a functional and dysfunctional PTT. The greatest angular changes were recorded during heel rise. For the normal foot, the small changes observed in the orientation of the hindfoot complex following release of the PTT load suggest that the intact osteo-ligamentous structure of the hindfoot is initially able to maintain normal alignment following acute PTT dysfunction. Once the soft tissues have been weakened, as in our flatfoot model, the PTT had little effect in overcoming the soft tissue laxity to correct the position of the foot.