Liu Yang, Lu Wen, Liu Wei, Wu Wang-Sheng, Wang Cheng-Wei
The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
Department of Orthopedics, The Second Affliated Hospital of Shandong First Medical University, Taian, China.
Sci Rep. 2025 Jul 22;15(1):26540. doi: 10.1038/s41598-025-11611-9.
Lisfranc injury is a complex trauma involving the midfoot joint, and treatment options range from conservative management to surgical intervention. Elastic fixation, an innovative surgical technique, has garnered attention for its ability to preserve the foot's biomechanical properties. However, the influence of pretension on the efficacy of elastic fixation remains unclear. This study aims to use three - dimensional (3D) finite element analysis (FEA) to examine the biomechanics of the Lisfranc joint under different pretension fixation states. It seeks to determine the optimal pretension for achieving the same biomechanical stability as normal ligaments. This will provide theoretical support for elastic fixation in treating Lisfranc injuries. The study analyzed stress distribution, von Mises stress, and displacement under different pretensions to assess the biomechanical stability of elastic fixation. Results showed that varying pretension levels differentially affected Lisfranc joint biomechanics. Specifically, increased pretension correlated with greater medial cuneiform-second metatarsal (MC1-MT2) joint space displacement and higher stress on the MC1, MT2, titanium plate, and tarsometatarsal joint cartilage. Nonetheless, each pretension level exhibited a unique stress distribution pattern. At 70 N of pretension, elastic fixation achieved biomechanical stability comparable to that of the normal foot model. This study demonstrates that elastic fixation can effectively restrict abnormal movements in the injured Lisfranc joint and identifies the optimal pretension for proper fixation.
Lisfranc损伤是一种涉及中足关节的复杂创伤，治疗方案从保守治疗到手术干预不等。弹性固定作为一种创新的手术技术，因其能够保留足部生物力学特性而受到关注。然而，预紧力对弹性固定效果的影响仍不明确。本研究旨在使用三维（3D）有限元分析（FEA）来研究不同预紧固定状态下Lisfranc关节的生物力学。它试图确定实现与正常韧带相同生物力学稳定性的最佳预紧力。这将为弹性固定治疗Lisfranc损伤提供理论支持。该研究分析了不同预紧力下的应力分布、von Mises应力和位移，以评估弹性固定的生物力学稳定性。结果表明，不同的预紧力水平对Lisfranc关节生物力学有不同影响。具体而言，预紧力增加与内侧楔骨-第二跖骨（MC1-MT2）关节间隙位移增大以及MC1、MT2、钛板和跗跖关节软骨上的应力升高相关。尽管如此，每个预紧力水平都呈现出独特的应力分布模式。在70 N的预紧力下，弹性固定实现了与正常足部模型相当的生物力学稳定性。本研究表明，弹性固定可以有效限制受伤Lisfranc关节的异常运动，并确定了合适固定的最佳预紧力。
