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胫骨内翻和外翻畸形时距下关节融合前后的踝关节压力变化

Ankle joint pressure change before and after subtalar joint arthrodesis in varus and valgus malalignment of the tibia.

作者信息

Hu Mu, Xu Xiangyang, Mei Jiong

机构信息

School of Medicine, 12476Tongji University, China.

Department of Orthopedics, 66281Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China.

出版信息

J Orthop Surg (Hong Kong). 2022 Jan-Apr;30(1):10225536221098478. doi: 10.1177/10225536221098478.

Abstract

The compensation mechanism of subtalar joint in ankle with varus or valgus deformity is controversial and not well established. This biomechanical study aims to investigate how subtalar joint arthrodesis will affect the ankle joint pressure in varus and valgus malalignment of the tibia. Eight fresh-frozen human cadaver legs were tested in this study. A custom-made fixture was utilized and a total of 600N was applied to simulate weight-bearing. Intra-articular sensors (TeckScan) were inserted in the ankle joint to demonstrate the ankle joint pressure. Conditions include: Neutral, 5°, 10°, 15° and 20° varus, 5°, 10°, 15° and 20° valgus. After the fusion of the subtalar joint, when the tibia is gradually inverted, the inside pressure of the ankle joint gradually increases, and the pressure on the outside of the ankle joint gradually decreases. When the tibia is gradually eversion, the pressure on the outside of the ankle joint gradually increases, and the inside of the ankle joint gradually decreases. After the subtalar joint is fused, the compensatory activity of the subtalar joint disappears, and the regulation of the pressure in the ankle joint will be lost. We hypothesized that the inversion compensation of the subtalar joint is more likely to occur than the eversion compensation.

摘要

距下关节在踝关节内翻或外翻畸形中的代偿机制存在争议且尚未完全明确。本生物力学研究旨在探讨距下关节融合术对胫骨内翻和外翻畸形时踝关节压力的影响。本研究对8条新鲜冷冻的人尸体下肢进行了测试。使用了定制的固定装置,并施加600N的力来模拟负重。将关节内传感器(TeckScan)插入踝关节以显示踝关节压力。测试条件包括:中立位、内翻5°、10°、15°和20°、外翻5°、10°、15°和20°。距下关节融合后,当胫骨逐渐内翻时,踝关节内侧压力逐渐增加,踝关节外侧压力逐渐降低。当胫骨逐渐外翻时,踝关节外侧压力逐渐增加,踝关节内侧压力逐渐降低。距下关节融合后,距下关节的代偿活动消失,踝关节内压力的调节功能丧失。我们假设距下关节的内翻代偿比外翻代偿更易发生。

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