ARCH STRAIN IN POSTERIOR TIBIAL TENDON DYSFUNCTION

胫骨后肌腱功能障碍引起的足弓拉伤

• 批准号: 2617934
• 负责人: JONATHAN T DELAND
• 金额: $ 15.38万
• 依托单位: HOSPITAL FOR SPECIAL SURGERY
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-08-01 至 2001-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2617934
• 关键词: ankle; foot; human tissue; ligaments; mechanical stress; musculoskeletal disorder; musculoskeletal injury; orthopedics; postmortem; statistics /biometry; tendon injury

DESCRIPTION (Adapted from the Applicant's Abstract): Posterior tibial tendon dysfunction (PTTD) results in a debilitating flatfoot deformity which is increasingly recognized as a major problem in the treatment of foot and ankle disorders. In fact, this disorder is felt to be the number one foot and ankle problem requiring intensive scientific investigation. The deformity is caused, at least in part, by the loss of the tendon function with subsequent muscle imbalance. Bony procedures without major fusions are being used in an effort to treat deformity when possible. However, with a tendon transfer of one third the muscle mass and a similarly smaller tendon, the original problem of muscle imbalance remains. If the problem of muscle imbalance and increased strain could be resolved, patients could be treated early to eliminate those factors that promote deformity and decreased function. This would make for a successful long-term result. A cadaveric model has been developed for the posterior tibial tendon deficient foot. Physiologic tendon, bone and ground reaction loads can be applied and monitored, and the resulting strain in the arch of the foot can be measured. Using this model, the following fundamental questions in the treatment of PTTD will be addressed: 1) does loss of the posterior tibial tendon increase strain in the arch and thereby promote deformity?; 2) how well does the present flexor digitorum tendon transfer replace the posterior tibial tendon muscle unit and does it leave muscle imbalance and increased strain in the arch?; 3) does a bony procedure, like a medial calcaneal displacement osteotomy, adequately assist the flexor digitorum tendon transfer?; and, most importantly, 4) if the flexor digitorum longus tendon transfer is inadequate (as would be expected based on clinical results), are there procedures that can adequately normalize strain and joint position?

描述（改编自申请人摘要）：胫骨后段 肌腱功能障碍（PTTD）导致衰弱性扁平足畸形， 越来越多地被认为是足部治疗中的主要问题， 脚踝疾病。 事实上，这种紊乱被认为是第一只脚 和脚踝问题需要深入的科学研究。 的 畸形至少部分是由肌腱功能丧失引起的 随后出现肌肉失衡 没有大融合的骨性手术是 在可能的情况下用于治疗畸形。 然而，随着一 肌腱转移三分之一的肌肉质量和类似的较小的肌腱， 肌肉不平衡的原始问题仍然存在。 如果肌肉的问题 失衡和压力增加可以得到解决，患者可以得到治疗 尽早消除那些促进畸形和减少 功能 这将有助于取得成功的长期成果。 在尸体 建立了胫后肌腱缺损足的模型。 可以施加生理肌腱、骨骼和地面反应载荷， 监测，并且可以测量足弓中产生的应变。 使用这个模型，在治疗中的以下基本问题 将讨论PTTD：1）胫骨后肌腱丢失 增加足弓的张力，从而促进畸形？2)有多好 本发明的指屈肌腱转移代替胫骨后段 肌腱肌肉单位和它是否离开肌肉不平衡和增加应变 在拱门上？3)做一个骨骼手术，比如跟骨内侧移位 截骨术是否能充分辅助屈指肌腱转移？并且，在本发明中， 最重要的是，4）如果趾长屈肌腱转移是 不充分（根据临床结果预期）， 可以充分恢复应变和关节位置的程序？