KINEMATICS AND STABILITY OF THE ARCH OF THE FOOT

据估计，美国有7400万人有脚 问题在所有年龄段的患者中最常见的足部疾病是pes 扁平或扁平足，这可能是一种痛苦的致残状况。有 关于最佳手术治疗方法的一些争论， 标准牙弓重建程序的缺点。的主要目标 拟议的调查是为了解决与以下方面有关的问题： 足弓的重建手术。更具体地说，两个 计划进行研究，以增加对足部力学的基本了解 通过分析拱的运动学和稳定性， 计划将结果应用于足弓重建的发展 程序. 研究1：关节的三维运动学和关节接触行为 正常足弓将在体外研究使用磁跟踪 生理负荷条件下的系统。结果将用于 测试假设。H1：牙弓的生理负荷导致 构成拱的所有接缝的显著位移， 关节接触特性的显著变化。 研究2：将在不同载荷下对尸体足标本进行测试 六个结构的连续切片稳定的条件 足弓造成足弓不稳定（扁平足或扁平足畸形）。 解剖元素将以不同的顺序进行切片， 确定每个结构对稳定性的相对贡献。两 假设（H2和H3）将被检验。H2：浅表三角肌， 距跟韧带是最重要的静态结构 负责保持足弓稳定。H3：总接头接触面积， 距舟关节和距下关节的接触分布是 扁平足明显改变。 研究3：使用来自第一和第二研究的数据，牙弓重建 将根据运动学和 稳定将检验两个假设（H4和H5）。H4：标准 例如屈趾长肌腱转移的手术不 有效地恢复牙弓或关节接触的对准或稳定性 特色H5：三角韧带前移显著改善 拱的线形和稳定性以及关节接触特性。

It is estimated that 74,000,000 people in the United States have foot problems. The most common foot disorder in patients of all ages is pes planus, or flat foot which may be a painful, disabling condition. There is some debate regarding the optimum surgical treatment method because of shortcomings of standard arch reconstruction procedures. The main goal of the proposed investigation is to address problems associated with reconstructive operations of the arch of the foot. More specifically, two studies are planned to increase the basic understanding of foot mechanics by analyzing the kinematics and stability of the arch, and a third study is planned to apply results toward the development of arch reconstruction procedures. Study l : Three-dimensional kinematics and joint contact behavior of the normal arch of the foot will be studied in vitro using a magnetic tracking system under physiological loading conditions. Results will be used to test the hypothesis. H1: Physiologic loading of the arch results in significant displacement of all the joints constituting the arch and significant changes in joint contact characteristics. Study 2: Cadaveric foot specimens will be tested under different loading conditions with sequential sectioning of six structures stabilizing the arch to create arch instability (pes planus or flat foot deformity). Anatomic elements will be sectioned in different sequences and the relative contribution of each structure to stability determined. Two hypotheses (H2 and H3) will be tested. H2: Superficial deltoid and talocalcaneal ligaments are the most important static structures responsible to maintain arch stability. H3: Total joint contact area and contact distribution at talonavicular and subtalar joints are significantly altered in pes planus. Study 3: Using data from first and second studies, arch reconstruction operations will be developed and compared based on kinematics and stability. Two hypotheses will be tested (H4 and H5). H4: Standard operations such as flexor digitorum longus tendon transfer do not effectively restore alignment or stability of the arch or joint contact characteristics. H5: Deltoid ligament advancement significantly improves arch alignment and stability and joint contact characteristics.