Uchiyama Eiichi, Kitaoka Harold B, Fujii Tadashi, Luo Zong-Ping, Momose Toshimitsu, Berglund Lawrence J, An Kai-Nan
Department of Anatomy, Sapporo University, Sapporo, Hokkaido, Japan.
Foot Ankle Int. 2006 Sep;27(9):723-7. doi: 10.1177/107110070602700912.
Abnormal gliding of the posterior tibial tendon may lead to mechanical trauma, degeneration, and eventually posterior tibial tendon dysfunction. Our study analyzed the gliding resistance of the posterior tibial tendon in intact feet and in feet with simulated flatfoot deformity.
An experimental system was developed that allowed direct measurement of gliding resistance at the tendon-sheath interface. Seven normal fresh-frozen cadaver foot specimens were studied, and gliding resistance between the posterior tibial tendon and sheath was measured. The effects of ankle and hindfoot position and the effect of flatfoot deformity on gliding resistance were analyzed. Gliding resistance was measured for 4.9 N applied load to the tendon.
Mean gliding resistance for the neutral position was 77 +/- 13.1 (x10(-2) N). Compared to neutral position, dorsiflexion increased gliding resistance and averaged 130 +/- 38.9 (x10(-2) N), and plantarflexion decreased gliding resistance and averaged 35 +/- 12.6 (x10(-2) N). Flatfoot deformity increased gliding resistance compared to normal feet, averaging 104 +/- 17.0 (x10(-2) N) for neutral, 205 +/- 55.0 (x10(-2) N) for dorsiflexion, and 58 +/- 21.3 (x10(-2) N) for plantarflexion.
The findings indicate that patients with a preexisting flatfoot deformity may be predisposed to develop posterior tibial tendon dysfunction because of increased gliding resistance and trauma to the tendon surface.
胫后肌腱异常滑动可能导致机械性损伤、退变，最终引发胫后肌腱功能障碍。我们的研究分析了完整足部及模拟扁平足畸形足部中胫后肌腱的滑动阻力。
开发了一个实验系统，可直接测量肌腱-腱鞘界面的滑动阻力。研究了7个正常的新鲜冷冻尸体足标本，测量了胫后肌腱与腱鞘之间的滑动阻力。分析了踝关节和后足位置以及扁平足畸形对滑动阻力的影响。对施加于肌腱的4.9 N负荷测量滑动阻力。
中立位的平均滑动阻力为77±13.1（×10⁻² N）。与中立位相比，背屈增加了滑动阻力，平均为130±38.9（×10⁻² N），跖屈降低了滑动阻力，平均为35±12.6（×10⁻² N）。与正常足相比，扁平足畸形增加了滑动阻力，中立位平均为104±—17.0（×10⁻² N），背屈时平均为205±55.0（×10⁻² N），跖屈时平均为58±21.3（×10⁻² N）。
研究结果表明，已有扁平足畸形的患者可能因滑动阻力增加及肌腱表面受到创伤而易于发生胫后肌腱功能障碍。
