中医正骨
中醫正骨
중의정골
THE JOURNAL OF TRADITIONAL CHINESE ORTHOPEDICS AND TRAUMATOLOGY
2014年
4期
3-6
,共4页
孙卫东%胡海威%温建民%桑志成%吴寿长%成永忠%余志勇%王庆雷
孫衛東%鬍海威%溫建民%桑誌成%吳壽長%成永忠%餘誌勇%王慶雷
손위동%호해위%온건민%상지성%오수장%성영충%여지용%왕경뢰
拇外翻%截骨术%有限元分析
拇外翻%截骨術%有限元分析
무외번%절골술%유한원분석
Hallux valgus%Osteotomy%Finite element analysis
目的：探讨拇外翻患者采用第1跖骨颈部微创截骨联合分趾垫和“8”字绷带外固定治疗后截骨端的稳定性和截骨愈合的生物力学机制。方法：选取1位青年女性拇外翻患者，年龄28岁，身高168 cm，体质量62 kg，右足拇外翻角24°，第1、2跖骨间角13°。利用其右足CT扫描所获得的数据建立右足拇外翻骨骼有限元模型，并模拟第1跖骨颈部微创截骨联合分趾垫和“8”字绷带外固定术，测定截骨端的Von Mises应力和位移。结果：截骨端X轴位移为0.261 mm，Y轴位移为0.078 mm，Z轴位移为-0.167 mm，截骨端总位移为0.293 mm；截骨端Von Mises应力为0.712 MPa，主要分布在截骨端的外侧边缘部位。结论：采用第1跖骨颈部微创截骨联合分趾垫和“8”字绷带外固定治疗拇外翻，截骨端之间位移小、应力适中，能使截骨端以软骨成骨的方式愈合。
目的：探討拇外翻患者採用第1蹠骨頸部微創截骨聯閤分趾墊和“8”字繃帶外固定治療後截骨耑的穩定性和截骨愈閤的生物力學機製。方法：選取1位青年女性拇外翻患者，年齡28歲，身高168 cm，體質量62 kg，右足拇外翻角24°，第1、2蹠骨間角13°。利用其右足CT掃描所穫得的數據建立右足拇外翻骨骼有限元模型，併模擬第1蹠骨頸部微創截骨聯閤分趾墊和“8”字繃帶外固定術，測定截骨耑的Von Mises應力和位移。結果：截骨耑X軸位移為0.261 mm，Y軸位移為0.078 mm，Z軸位移為-0.167 mm，截骨耑總位移為0.293 mm；截骨耑Von Mises應力為0.712 MPa，主要分佈在截骨耑的外側邊緣部位。結論：採用第1蹠骨頸部微創截骨聯閤分趾墊和“8”字繃帶外固定治療拇外翻，截骨耑之間位移小、應力適中，能使截骨耑以軟骨成骨的方式愈閤。
목적：탐토무외번환자채용제1척골경부미창절골연합분지점화“8”자붕대외고정치료후절골단적은정성화절골유합적생물역학궤제。방법：선취1위청년녀성무외번환자，년령28세，신고168 cm，체질량62 kg，우족무외번각24°，제1、2척골간각13°。이용기우족CT소묘소획득적수거건립우족무외번골격유한원모형，병모의제1척골경부미창절골연합분지점화“8”자붕대외고정술，측정절골단적Von Mises응력화위이。결과：절골단X축위이위0.261 mm，Y축위이위0.078 mm，Z축위이위-0.167 mm，절골단총위이위0.293 mm；절골단Von Mises응력위0.712 MPa，주요분포재절골단적외측변연부위。결론：채용제1척골경부미창절골연합분지점화“8”자붕대외고정치료무외번，절골단지간위이소、응력괄중，능사절골단이연골성골적방식유합。
Objective:To study the stability of the end of the cut bone and the biomechanical mechanism of cut bone healing in the pa-tients with hallux valgus treated with mini-invasive osteotomy in the first metatarsal neck combined with hallux valgus splint and figure-of-eight bandage fixation. Methods:One female with hallux valgus( age 28 years,height 168 cm,body mass 62 kg)was selected. Her right hallux valgus angle was 24 degree and her intermetatarsal angle was 13 degree. The finite element model of right foot hallux valgus was built by using CT data,and the Von Mises stress and displacement were measured after simulating mini-invasive osteotomy in the first metatar-sal neck combined with hallux valgus splint and figure-of-eight bandage fixation. Results:The displacement in X-axis was 0. 261 mm, the displacement in Y-axis was 0. 078 mm,the displacement in Z-axis was -0. 167 mm,and the total displacement was 0. 293 mm. The Von Mises stress was 0. 712 Mpa and was mainly distributed at the lateral margin of the end of the cut bone. Conclusion:In the treatment of hallux valgus,the therapy of mini-invasive osteotomy in the first metatarsal neck combined with hallux valgus splint and figure-of-eight bandage fixation has such advantages as small displacement,moderate stress,furthermore,the end of the cut bone can be united by means of os cartilaginea.
