Yu Xiao, Pang Qing-Jiang, Chen Xian-Jun
Dr. Xiao Yu, PhD. Department of Orthopedics, Ningbo NO.2 Hospital, Ningbo, 315010, China.
Dr. Qing-jiang Pang, PhD. Department of Orthopedics, Ningbo NO.2 Hospital, Ningbo, 315010, China.
Pak J Med Sci. 2017 Jan-Feb;33(1):146-150. doi: 10.12669/pjms.331.11908.
To study the influence of forefoot plantar pressure of the first tarsometatarsal joint fracture-dislocation by three different implants to provide experimental reference in selecting implants.
Eight fresh foot specimens were made into the models of the first tarsometatarsal joint fracture-dislocation, which were fixed with 3.5 mm cortical screw, 1/4 tubular plate and compressive staple in turn. After the loading of 600N, the changes of the plantar pressure in forefoot were measured by the method of the F-scan plantar pressure system.
After first tarsometatarsal joint fracture-dislocation, the peak pressure under the first metatarsal head would decrease, while the pressure under the second metatarsal head would increase(<0.05). When the first tarsometatarsal joint was fixed with screw or plate respectively; the peak pressure under the two metatarsal heads would tend to be normal. However, the staple fixation would show the statistical significant difference, although the peak pressure under the first and second metatarsal heads were recovered in some extent(<0.05).
After the first tarsometatarsal joint fracture-dislocation, the plantar pressure might be compensated partly by the adjacent metatarsal heads. While the first tarsometatarsal joint fracture-dislocation was fixed by screw or plate, the plantar pressure of the forefoot would return to the normal state. However, if the joint was fixed by the staple, it would still be difficult to return the plantar pressure to be normal.
研究三种不同内固定物对第一跖跗关节骨折脱位前足跖压力的影响，为临床选择内固定物提供实验依据。
取8例新鲜足标本制作第一跖跗关节骨折脱位模型，依次用3.5mm皮质骨螺钉、1/4管型钢板及加压骑缝钉固定。加载600N力后，采用F-scan足底压力系统测量前足跖压力变化。
第一跖跗关节骨折脱位后，第一跖骨头下峰值压力降低，第二跖骨头下压力升高（<0.05）。分别采用螺钉或钢板固定第一跖跗关节后，两跖骨头下峰值压力趋于正常。而采用骑缝钉固定虽两跖骨头下峰值压力有一定恢复，但差异有统计学意义（<0.05）。
第一跖跗关节骨折脱位后，前足跖压力可由相邻跖骨头部分代偿。采用螺钉或钢板固定第一跖跗关节后，前足跖压力可恢复正常；而采用骑缝钉固定，前足跖压力仍难以恢复正常。
