Abstract:
Medial displacement calcaneal osteotomy (MDCO) is the standard procedure for flatfoot. We investigated the effect of MDCO on the foot using a finite element analysis. Foot models were created from computed tomography data of 8 patients with flat feet. MDCO was performed on each model with bone translation distance of 4, 8, and 12 mm. The morphological changes, plantar pressures, and stress percentage on the talocrural and subtalar joints were evaluated before and after surgery. Morphological evaluation showed improvement in the medial longitudinal arch. The stress percentage of plantar pressure in the medial area decreased, and the stress percentage of plantar pressure in the mid- and lateral forefoot area increased. At the talocrural joint, the medial and middle stress percentage increased, while the lateral and posterior stress percentage decreased. In the subtalar joint, the stress percentage in the middle subtalar joint increased and that in the posterior subtalar joint decreased. Within the posterior subtalar joint, the anterior and medial stress percentage increased, while the posterior and lateral stress percentage decreased. Preoperative simulation using the finite element analysis may be useful in understanding postoperative morphological changes and loading conditions to perform patient-specific surgery.
摘要:
内侧移位跟骨截骨术(MDCO)是扁平足的标准手术。我们使用有限元分析研究了MDCO对足部的影响。根据8位扁平足患者的计算机断层扫描数据创建脚模型。在骨平移距离为4、8和12mm的每个模型上进行MDCO。形态变化,足底压力,并在手术前后评估距骨和距下关节的应力百分比。形态学评估显示内侧纵弓有所改善。内侧区域足底压力的应力百分比下降,前足中外侧足底压力的应力百分比增加。在骨关节,内侧和中间应力百分比增加,而侧向和后部应力百分比下降。在距下关节,中距下关节的应力百分比增加,距下关节的应力百分比减少。在后距下关节内,前部和中部应力百分比增加,而后部和侧向应力百分比下降。使用有限元分析的术前模拟可能有助于了解术后形态变化和负荷状况,以进行针对患者的手术。