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马蹄足截骨方案的生物力学数值计算及评估

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背景:僵硬性马蹄的畸形情况十分复杂,使用CT影像等常见的临床诊断手段无法精确地描述足部畸形情况,很难依据其畸形的特点制定截骨方案.目的:根据僵硬性马蹄足患者CT数据,创建三维僵硬性马蹄内翻足有限元模型,对患者截骨进行数值模拟并分析术后的跖骨应力状况、跖骨下方深层软组织的高应力区和内侧足弓的位移,为截骨方案的选择提供依据.方法:利用志愿者足部的CT断层扫描数据对双足进行拟向重构得到结构完整的、几何高相似度的有限元模型,对胫骨根骨角分别为0°、外翻3°、外翻5°三种截骨方案进行数值模拟,使用上述生物力学特性量化评估术后效果.结果与结论:当截骨方案中胫骨根骨角度由0°增加到5°时,应力集中同足承载重心逐渐由第4、5跖骨向第2跖骨转移,更符合正常足的受力情况,在外翻5°时骨组织应力分布及软组织应力集中情况最佳;但内侧足弓位移先增大后减小,在3°达到时最大值4.2mm,考虑减少患者病痛、增强治疗效果外翻5°为最佳截骨方案.
Biomechanical Numerical Calculation and Evaluation of Equine Hoof Foot Osteotomy
Background:The deformities of rigid equinovarus foot are very complex.The common clinical diagnostic methods such as CT imaging cannot accurately describe the deformities of the foot,and it is difficult to make surgical plans according to the characteristics of the deformities.Objective:Based on the CT data of patients with rigid equinovarus foot,a three-dimensional fi-nite element model of rigid equinovarus varus was created.The numerical simulation was conducted for patients undergoing sur-gery,and the stress concentration of the metatarsal bone,the high stress area of the deep soft tissue below the metatarsal bone and the displacement of the medial arch were analyzed.To provide the basis for the selection of surgical plan.Methods:Using the foot CT scan data of volunteers,foot pseudo-directional reconstruction was carried out to obtain the finite element model with complete structure and high geometric similarity,and the three surgical schemes were numerically simulated,and the biomechanical prop-erties of the foot were quantitatively evaluated.Results & Conclusions:When the Angle of tibial root bone increased in the osteoto-my program,the stress concentration of the same foot gradually shifted from the fourth and fifth metatarsal bone to the second metatarsal bone,which was more in line with the stress situation of normal foot.The stress distribution of bone tissue and soft tissue stress concentration were the best when the valgus was 5°.However,the displacement of the medial arch first increased and then de-creased,and the maximum value was 4.2mm when 3 was reached.Considering that reducing the pain of patients and enhancing the therapeutic effect of version 5°is the best surgical scheme.

Equinovarus FootReverse EngineeringBiomechanicsFinite Element Analysis

于天翔、海几哲、杨清炜、王丽红

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新疆大学机械工程学院,新疆 乌鲁木齐 830008

机械制造系统工程国家重点实验室,陕西 西安 710049

马蹄足 逆向工程 生物力学 有限元分析

2024

机械设计与制造
辽宁省机械研究院

机械设计与制造

CSTPCD北大核心
影响因子:0.511
ISSN:1001-3997
年,卷(期):2024.406(12)