Biomechanical consequences of lateral column lengthening of the calcaneus: Part I. Long plantar ligament strain.
Biomechanical consequences of lateral column lengthening of the calcaneus: Part I. Long plantar ligament strain.
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DOI：
10.1053/j.jfas.2003.11.013
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发表时间：
2004-01-01
期刊：
影响因子：
--
通讯作者：
Dinucci, Kris A
中科院分区：
文献类型：
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作者：
Dinucci, Kent R;Christensen, Jeffrey C;Dinucci, Kris A
跟骨外侧柱延长术已成为一种有效的方法，用于矫正扁平足足周围半脱位。用这种方法进行校正的机械基础和限制还没有很好地理解。在8只新鲜冷冻尸体足上，通过切割三角韧带、距舟囊和弹簧韧带建立扁平足模型。当外侧柱以2 mm增量从4 mm依次延长至12 mm时，对长足底韧带进行应变计分析（6个样本）。结果表明，在此过程中，只有最外侧的三分之一的足底长韧带测得正应变。在延长过程中，足底长韧带和足底筋膜的内侧三分之二的张力降低，并完全松弛。在放置厚度为6 mm的移植物后测量长足底韧带的最大张力（P 6 mm没有额外的矫正能力而不损害长足底韧带）。较大的移植物尺寸或长足底韧带的损失可能会损害足部外侧柱的内在稳定性。这些发现可能会降低该手术并发症的发生率，特别是外侧柱疼痛、不稳定和跟骰关节病。
Lateral column lengthening of the calcaneus has been a powerful tool used to correct peritalar subluxation in symptomatic flat feet. The mechanical basis and limits for correction with this procedure are not well understood. A flatfoot model was created on 8 fresh-frozen cadaver feet by sectioning the deltoid ligament, talonavicular capsule, and spring ligament. Strain-gauge analysis of the long plantar ligament was performed (on 6 specimens) as the lateral column was sequentially lengthened from 4 to 12 mm in 2-mm increments. Results showed that only the lateral most one-third of the long plantar ligament measured positive strain during this procedure. The medial two-thirds of the long plantar ligament and plantar fascia decreased in tension and became fully lax during lengthening. Maximum tension in the long plantar ligament was measured after placing grafts 6 mm in thickness (P 6 mm have no additional corrective capacity without compromising the long plantar ligament. Either larger graft size or loss of the long plantar ligament could compromise the intrinsic stability of the lateral column of the foot. These findings may decrease the incidence of complications with this procedure, specifically lateral column pain, instability, and calcaneocuboid arthrosis.