Towards patient-specific medializing calcaneal osteotomy for adult flatfoot: a finite element study
Towards patient-specific medializing calcaneal osteotomy for adult flatfoot: a finite element study
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DOI：
10.1080/10255842.2018.1452202
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发表时间：
2018-03
影响因子：
1.6
通讯作者：
Zhongkui Wang;Masamitsu Kido;Kan Imai;K. Ikoma;S. Hirai
中科院分区：
文献类型：
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作者：
Zhongkui Wang;Masamitsu Kido;Kan Imai;K. Ikoma;S. Hirai
摘要在临床上，由于扁平足患者的畸形个体差异，在跟骨内侧截骨术（MCO）中，足踝外科医生面临着选择合适手术参数的困难。传统的尸体研究提供了关于肌腱、韧带和足底筋膜的生物力学效应的重要信息，但在处理个体差异和定制患者特定手术时已经达到了局限性。因此，本研究旨在实施有限元（FE）方法来研究不同MCO参数的影响，以帮助足踝外科医生执行针对患者的手术。本研究以电脑断层摄影（CT）影像为基础，建构扁平足与健足的有限元模型。在用实验测量验证了有限元模型后，比较了两种模型之间足底应力的差异，并建立了评估手术模拟性能的标准。四个MCO参数，然后通过有限元模拟进行了研究。结果表明，横向角β和平移距离d影响手术性能。因此，在临床上选择这两个参数时应特别注意。然而，发现矢状角α和截骨位置p对MCO性能的影响较小。
Abstract Clinically in medializing calcaneal osteotomy (MCO), foot and ankle surgeons are facing difficulties in choosing appropriate surgical parameters due to the individual differences in deformities among flatfoot patients. Traditional cadaveric studies have provided important information regarding the biomechanical effects of tendons, ligaments, and plantar fascia, but limitations have been reached when dealing with individual differences and tailoring patient-specific surgeries. Therefore, this study aimed at implementing the finite element (FE) method to investigate the effect of different MCO parameters to help foot and ankle surgeons performing patient-specific surgeries. This study constructed FE models of a flatfoot and a healthy foot based on computed tomography (CT) images. After validating the FE models with experimental measurements, differences in plantar stress were compared between two models and a criterion was established for evaluating the performance of surgical simulations. Four MCO parameters were then studied through FE simulations. Results suggested that the transverse angle, β, and translation distance, d, affected surgical performance. Therefore, special attentions may be recommended when choosing these two parameters clinically. However, the sagittal angle, α, and osteotomy position, p, were found to have less effect on the MCO performance.