KINEMATICS AND STABILITY OF THE ARCH OF THE FOOT

足弓的运动学和稳定性

• 批准号: 6171306
• 负责人: HAROLD B KITAOKA
• 金额: $ 12.2万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-01 至 2002-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6171306
• 关键词: ankle; arthrodesis; biomechanics; clinical research; elasticity; evaluation /testing; foot; gait; human tissue; joint ligament; mechanical pressure; orthopedics; skeletal disorder; skeletal stress; statistics /biometry; tendons; tibia

The arch of the foot is important in performing activities to provide a stable base for weight bearing, flexibility to accommodate different ground conditions, and also to dissipate loads from weight bearing. The arch is constrained by bony and articular geometry, ligaments, joint capsules, and fascia. Posterior tibial tendon dysfunction (PTTD) is associated with loss of these constraints, leading to pain, impaired function, and flatfoot deformity. This study will focus upon four specific aims related to function of the arch and to mechanical behavior of the foot with orthoses or reconstruction procedures for PTTD and flatfoot. Hypothesis 1: Normal gait may be observed in vitro with a dynamic ankle simulator. Specific Aim 1: To determine foot and ankle kinematics, ground reaction force, and center of pressure advancement in level walking in normals. Hypothesis 2: Posterior tibial tendon dysfunction and flatfoot are associated with markedly abnormal foot and ankle kinematics, ground reaction force, and center of pressure advancement in level walking. Specific Aim 2: To determine foot and ankle kinematics in cadaveric feet with simulated posterior tibial tendon dysfunction and flatfoot and compare results with normals. Hypothesis 3: Hindfoot orthoses (HFO) improve foot and ankle function in feet with posterior tibial tendon dysfunction and flatfoot on level walking. Specific Aim 3: To evaluate mechanical behavior of the foot and ankle with posterior tibial tendon dysfunction and flatfoot treated with articulated and nonarticulated HFO on level walking. Hypothesis 4: Reconstruction operations for posterior tibial tendon dysfunction and flatfoot which do not involve extensive arthrodesis improve foot and ankle function in level walking. Specific Aim 4: To evaluate mechanical behavior of the foot and ankle with three recently developed and yet to be proven operations for posterior tibial tendon dysfunction and flatfoot: lateral column lengthening (LCL), medial displacement calcaneal osteotomy (MDO), and Giannini subtalar implant.

足弓在进行活动时很重要，它为负重提供稳定的基础，灵活地适应不同的地面条件，也可以减轻负重的负荷。弓受骨和关节几何形状、韧带、关节囊和筋膜的约束。胫骨后腱功能障碍（PTTD）与这些约束的丧失有关，导致疼痛、功能受损和扁平足畸形。本研究将集中在与足弓功能和足部机械行为相关的四个具体目标上，这些目标与PTTD和扁平足的矫形器或重建程序有关。假设1：可以用动态踝关节模拟器在体外观察正常步态。具体目标1：在正常水平行走中确定足部和踝关节运动学，地面反作用力和压力中心前进。假设2：胫骨后腱功能障碍和扁平足与水平行走时足部和踝关节运动、地面反作用力和压力中心的明显异常有关。具体目标2：确定模拟胫骨后腱功能障碍和扁平足的尸体足的足部和踝关节运动学，并将结果与正常人进行比较。假设3：后足矫形器（HFO）可改善胫骨后腱功能障碍和平足行走的足部和踝关节功能。具体目的3：评估关节和非关节HFO治疗胫骨后腱功能障碍和扁平足的足和踝关节在水平行走中的力学行为。假设4：不涉及广泛关节融合术的胫骨后腱功能障碍和扁平足重建手术可改善水平行走时的足和踝关节功能。具体目标4：评估足和踝关节的力学行为与三种最近开发的，尚未被证实的手术治疗胫骨后肌腱功能障碍和扁平足：外侧柱延长（LCL），内侧位移跟骨截骨（MDO）和距下Giannini植入物。