Jiao Xin, Hu Tianyi, Li Yongjin, Wang Binbin, Acquah Mirabel Ewura Esi, Wang Zengguang, Chen Qianqian, Gan Yaokai, Gu Dongyun
Shanghai Key Laboratory of Orthopedic Implant, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China.
Bioengineering (Basel). 2024 Jul 18;11(7):728. doi: 10.3390/bioengineering11070728.
Flatfoot is a common foot deformity, causing foot pain, osteoarthritis of the midfoot, and even knee and hip dysfunction. The elastic modulus of foot soft tissues and its association with gait biomechanics still remain unclear. For this study, we recruited 20 young individuals with flatfoot and 22 age-matched individuals with normal foot arches. The elastic modulus of foot soft tissues (posterior tibial tendon, flexor digitorum brevis, plantar fascia, heel fat pad) was obtained via ultrasound elastography. Gait data were acquired using an optical motion capture system. The association between elastic modulus and gait data was analyzed via correlation analysis. The elastic modulus of the plantar fascia (PF) in individuals with flatfoot was higher than that in individuals with normal foot arches. There was no significant difference in the elastic modulus of the posterior tibial tendon (PTT), the flexor digitorum brevis (FDB), or the heel fat pad (HFD), or the thickness of the PF, PTT, FDB, and HFD. Individuals with flatfoot showed greater motion of the hip and pelvis in the coronal plane, longer double-support phase time, and greater maximum hip adduction moment during walking. The elastic modulus of the PF in individuals with flatfoot was positively correlated with the maximum hip extension angle (r = 0.352, = 0.033) and the maximum hip adduction moment (r = 0.429, = 0.039). The plantar fascia is an important plantar structure in flatfoot. The alteration of the plantar fascia's elastic modulus is likely a significant contributing factor to gait abnormalities in people with flatfoot. More attention should be given to the plantar fascia in the young population with flatfoot.
扁平足是一种常见的足部畸形，会导致足部疼痛、中足骨关节炎，甚至膝关节和髋关节功能障碍。足部软组织的弹性模量及其与步态生物力学的关系仍不明确。在本研究中，我们招募了20名患有扁平足的年轻人和22名年龄匹配的足弓正常的个体。通过超声弹性成像获得足部软组织（胫后肌腱、趾短屈肌、足底筋膜、足跟脂肪垫）的弹性模量。使用光学运动捕捉系统采集步态数据。通过相关性分析弹性模量与步态数据之间的关系。扁平足个体的足底筋膜（PF）弹性模量高于足弓正常个体。胫后肌腱（PTT）、趾短屈肌（FDB）或足跟脂肪垫（HFD）的弹性模量，以及PF、PTT、FDB和HFD的厚度均无显著差异。扁平足个体在冠状面的髋部和骨盆运动更大，双支撑相时间更长，行走时最大髋内收力矩更大。扁平足个体的PF弹性模量与最大髋伸展角度（r = 0.352，P = 0.033）和最大髋内收力矩（r = 0.429，P = 0.039）呈正相关。足底筋膜是扁平足中重要的足底结构。足底筋膜弹性模量的改变可能是扁平足患者步态异常的一个重要因素。对于患有扁平足的年轻人群，应更多地关注足底筋膜。
