Biomechanical evaluation of the efficacy of external stabilizers in the conservative treatment of acquired flatfoot deformity
Biomechanical evaluation of the efficacy of external stabilizers in the conservative treatment of acquired flatfoot deformity
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DOI：
10.1177/107110070202300809
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发表时间：
2002-08-01
影响因子：
2.7
通讯作者：
Siegler, S
中科院分区：
文献类型：
--
作者：
Imhauser, CW;Abidi, NA;Siegler, S
这项研究量化并比较了鞋内矫形器和踝关节支架在获得性柔性平足畸形尸体模型中稳定后足和内侧纵弓的功效。通过将后足和足弓运动学的测量与足底压力分布相结合来解决这个问题，足底压力分布是响应模拟安静站立的轴向载荷而产生的。实验在六具新鲜冷冻的尸体下肢上进行。测试了三种情况：完整无支撑；扁平足——无支撑；和扁平足支撑。平足畸形是通过剖切内侧纵弓的主要支撑结构而产生的。测试了六种不同的矫形器，包括两种鞋内矫形器、三种踝部矫形器和一种模制踝足矫形器。我们的柔性平足畸形模型导致跟骨外翻、距骨跖屈以及距骨和内侧楔骨的高度降低。柔性平足畸形导致足底压力分布向内侧移动，但压力中心位置的变化很小。此外，鞋内矫形器可以稳定后足和内侧纵弓，而踝关节支架则不能。半刚性足部和踝部矫形器可稳定内侧纵弓。基于这些结果，得出的结论是，扁平足畸形的治疗至少应包括使用鞋内矫形器来部分恢复足弓并稳定后足。
This study quantified and compared the efficacy of in-shoe orthoses and ankle braces in stabilizing the hindfoot and medial longitudinal arch in a cadaveric model of acquired flexible flatfoot deformity. This was addressed by combining measurement of hindfoot and arch kinematics with plantar pressure distribution, produced in response to axial loads simulating quiet standing. Experiments were conducted on six fresh-frozen cadaveric lower limbs. Three conditions were tested: intact-unbraced; flatfoot-unbraced; and flatfoot-braced. Flatfoot deformity was created by sectioning the main support structures of the medial longitudinal arch. Six different braces were tested including two in-shoe orthoses, three ankle braces and one molded ankle-foot orthosis.Our model of flexible flatfoot deformity caused the calcaneus to evert, the talus to plantarflex and the height of the talus and medial cuneiform to decrease. Flexible flatfoot deformity caused a pattern of medial shift in plantar pressure distribution, but minimal change in the location of the center of pressure. Furthermore, in-shoe orthoses stabilized both the hindfoot and the medial longitudinal arch, while ankle braces did not. Semi-rigid foot and ankle orthoses acted to stabilize the medial longitudinal arch. Based on these results, it was concluded that treatment of flatfoot deformity should at least include use of in-shoe orthoses to partially restore the arch and stabilize the hindfoot.