Stress analysis of the standing foot following surgical plantar fascia release
Stress analysis of the standing foot following surgical plantar fascia release
复制标题
DOI：
10.1016/s0021-9290(01)00242-1
复制
发表时间：
2002-05-01
影响因子：
2.4
通讯作者：
Gefen, A
中科院分区：
文献类型：
--
作者：
Gefen, A
足底筋膜松解术是因足底筋膜炎而导致慢性足跟痛且不受保守治疗影响的患者的手术替代方案。一个计算（有限元）模型，用于分析在站立过程中的人脚的结构行为，研究生物力学的影响，释放足底筋膜。该模型集成了一个系统的五个平面结构的脚射线的方向。它是根据MRI的精确几何数据构建的，包括代表骨、软骨、韧带和脂肪组织的线性和非线性元素。该模型成功地验证了其产生的地面反应与脚地面压力测量和预测的位移与放射性试验中观察到的。足底筋膜释放（部分或全部）的模拟通过逐渐去除模型中的部分筋膜来完成。结果表明，总筋膜释放引起广泛的足弓变形在站立，这是大于正常变形超过2.5毫米。长足底韧带进行的张力应力显着增加，并可能超过正常的平均应力超过200%。由于足底筋膜对足部承重能力的贡献是非常重要的，因此必须非常仔细地考虑其释放，并且本模型可用于帮助外科医生决定所需的释放程度。(C)2002爱思唯尔科技有限公司。保留所有权利。
Plantar fascia release is a surgical alternative for patients who suffer chronic heel pain due to plantar fasciitis and are unaffected by conservative treatment. A computational (finite element) model for analysis of the structural behavior of the human foot during standing was utilized to investigate the biomechanical effects of releasing the plantar fascia. The model integrates a system of five planar structures in the directions of the foot rays. It was built according to accurate geometric data of MRI, and includes linear and non-linear elements that represent bony, cartilaginous, ligamentous and fatty tissues. The model was successfully validated by comparing its resultant ground reactions with foot-ground pressure measurements and its predicted displacements with those observed in radiological tests. Simulation of plantar fascia release (partial or total) was accomplished by gradually removing parts of the fascia in the model. The results showed that total fascia release causes extensive arch deformation during standing, which is greater than normal deformation by more than 2.5 mm. Tension stresses carried by the long plantar ligaments increased significantly, and may exceed the normal average stress by more than 200%. Since the contribution of the plantar fascia to the foot's load-bearing ability is of major importance, its release must be very carefully considered, and the present model may be used to help surgeons decide upon the desired degree of release. (C) 2002 Elsevier Science Ltd. All rights reserved.