Liu Songbo, Huang Dong, Huang Yongjun, Liu Weijie, Liu Xiaochun
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 Jan;30(1):60-4.
To explore the feasibility of Lisfranc ligament reconstruction with autogenous tendon through biomechanical testing.
Twelve fresh-frozen cadaveric lower limbs were prepared three sequential testing conditions: intact Lisfranc ligament (intact group), disrupted Lisfranc ligament (disrupted group), and Lisfranc ligament reconstruction (reconstruction group). Under fixing on the Bose mechanical test machine, three models were given 0-600 N axial loading in the neutral position and the plantar flexion of 30 degrees according to the speed of 10 N/s, every 100 N load with a 1-minute interval. The medial cuneiform (C1) and the second metatarsal (M2) base displacement and the foot transverse arch height were recorded under different loads.
In the neutral position and the plantar flexion of 30 degrees, C1-M2 displacement and foot transverse arch height showed an increasing trend with increased load under 0-600 N axial loading. There were significant differences in C1-M2 displacement variation in 2 positions among groups (P < 0.05). In disrupted group, the C1-M2 displacement variation in neutral position was significantly lower than that in plantar flexion of 30 degrees (t = 7.392, P = 0.000). In the neutral position, the foot transverse arch height variation in the disrupted group and the reconstruction group was significantly higher than that in the intact group (P < 0.05), but there was no significant difference between the disrupted group and reconstruction group (P > 0.05).
Lisfranc ligament reconstruction with autogenous tendon can reduce the C1-M2 displacement variation and stabilize Lisfranc joint to a certain degree. Reconstruction of both dorsal ligament and Lisfranc ligament will not improve the buffering capacity. The C1-M2 displacement variation in the plantar flexion of 30 degrees is more obvious than that in neutral position, so it is helpful to improve clinical diagnosis of occult Lisfranc damage.
通过生物力学测试探讨自体肌腱重建Lisfranc韧带的可行性。
准备12具新鲜冷冻尸体下肢，设置三种连续测试条件：完整Lisfranc韧带（完整组）、Lisfranc韧带断裂（断裂组）和Lisfranc韧带重建（重建组）。将三种模型固定在Bose力学试验机上，在中立位和30°跖屈位按照10 N/s的速度施加0 - 600 N轴向载荷，每100 N载荷间隔1分钟。记录不同载荷下内侧楔骨（C1）和第二跖骨（M2）基底位移以及足横弓高度。
在中立位和30°跖屈位，0 - 600 N轴向载荷下，C1 - M2位移和足横弓高度随载荷增加呈上升趋势。组间2个位置的C1 - M2位移变化存在显著差异（P < 0.05）。在断裂组，中立位的C1 - M2位移变化显著低于30°跖屈位（t = 7.392，P = 0.000）。在中立位，断裂组和重建组的足横弓高度变化显著高于完整组（P < 0.05），但断裂组和重建组之间无显著差异（P > 0.05）。
自体肌腱重建Lisfranc韧带可减少C1 - M2位移变化，在一定程度上稳定Lisfranc关节。背侧韧带和Lisfranc韧带同时重建并不能提高缓冲能力。30°跖屈位的C1 - M2位移变化比中立位更明显，有助于提高隐匿性Lisfranc损伤的临床诊断。
