Hadfield Mark H, Snyder John W, Liacouras Peter C, Owen Johnny R, Wayne Jennifer S, Adelaar Robert S
Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, VA, USA.
Foot Ankle Int. 2003 Jul;24(7):523-9. doi: 10.1177/107110070302400703.
Posterior tibial tendon insufficiency, or adult acquired flatfoot deformity, involves collapse of the longitudinal arch of the foot with ensuing changes in the bony architecture of the foot as well. While it is generally accepted that a medializing calcaneal osteotomy (MCO) is a very useful treatment for restoring the fallen arch, questions regarding the effects of this procedure upon plantar foot pressures and Achilles tendon length changes need to be answered. This study focuses on changes in plantar foot pressures and Achilles tendon length as the result of performing a MCO. Fourteen fresh-frozen cadaver legs were used to test the effects of MCO on Achilles tendon length changes 2 cm proximal to the Achilles tendon insertion on the calcaneus. Differential variable reluctance transducers were anchored in ventromedial, dorsomedial, dorsolateral, and ventrolateral positions of the Achilles tendon at the aforementioned level. The effects of the MCO on plantar foot pressures were assessed simultaneously using the Tekscan HR Mat. Axial loading (100 lbs) of each specimen was performed in neutral and dorsiflexion (15 degrees). Data were gathered for Achilles tendon length changes and plantar foot pressures for three trials in both the neutral and dorsiflexed positions. A medializing calcaneal osteotomy (1 cm medial translation) was then performed and testing was repeated in the fashion outlined heretofore. Analysis of the data revealed that there was no significant increase in Achilles tendon length as a result of the MCO. The data also showed that average pressure over the first and second metatarsal regions of the forefoot decreased significantly after MCO. At the same time there was a significant increase in average pressure over the medial and lateral aspect of the heel. These findings suggest that the Achilles tendon aids in inversion of the forefoot without undergoing a significant increase in length change of Achilles tendon fibers in any of the regions tested.
胫后肌腱功能不全，即成人获得性平足畸形，包括足纵弓塌陷以及随之而来的足部骨结构变化。虽然一般认为内侧移位跟骨截骨术（MCO）是恢复塌陷足弓的一种非常有效的治疗方法，但该手术对足底压力和跟腱长度变化的影响问题仍需解答。本研究聚焦于实施MCO后足底压力和跟腱长度的变化。使用14条新鲜冷冻的尸体下肢来测试MCO对跟腱在跟骨附着点近端2厘米处长度变化的影响。差动可变磁阻传感器固定在上述水平跟腱的腹内侧、背内侧、背外侧和腹外侧位置。使用Tekscan HR Mat同时评估MCO对足底压力的影响。对每个标本在中立位和背屈位（15度）进行轴向加载（100磅）。在中立位和背屈位分别进行三次试验，收集跟腱长度变化和足底压力数据。然后进行内侧移位跟骨截骨术（向内侧平移1厘米），并按上述方式重复测试。数据分析显示，MCO后跟腱长度没有显著增加。数据还表明，MCO后前足第一和第二跖骨区域的平均压力显著降低。与此同时，足跟内侧和外侧的平均压力显著增加。这些发现表明，在测试的任何区域，跟腱有助于前足内翻，而跟腱纤维的长度变化没有显著增加。
Zotero 插件