Rosenbaum D, Bauer G, Augat P, Claes L
Abteilung Unfallchirurgische Forschung und Biomechanik, Universität Ulm, Germany.
J Biomech. 1996 Nov;29(11):1435-43. doi: 10.1016/0021-9290(96)84539-8.
In order to evaluate the effects of the anatomical changes after calcaneal fractures on joint loading characteristics we investigated the effects of simulated calcaneal fractures on intra-articular loading in the Chopart joint and on plantar pressure patterns in vitro. Five fresh-frozen lower leg specimens were axially loaded with 500 N in three positions: neutral, 10 degrees plantarflexion and 10 degrees dorsiflexion. The loading characteristics were determined before and after creating a tongue-type fracture by osteotomy. Plantar loading patterns were measured with a capacitive pressure distribution platform. Intra-articular contact areas and pressures were recorded on pressure sensitive film introduced into the talonavicular and calcaneocuboid joint. Increased loading in the calcaneocuboid joint (+25%,p = 0.005) and decreased loading in the talonavicular joint (-16%,p = 0.01) corresponded to increased loading of the lateral aspects of the plantar surface. These findings were independent of the foot position. The results suggest that the effects of increased lateral foot loading which have been observed in calcaneal fracture patients (Rosenbaum et al., Clin. Biomech. 10, 345-351, 1995) are caused by changes in joint kinematics and do not appear to result from a protective gait pattern established after the injury.
为了评估跟骨骨折后解剖结构变化对关节负荷特征的影响，我们在体外研究了模拟跟骨骨折对Chopart关节内负荷以及足底压力模式的影响。五个新鲜冷冻的小腿标本在三个位置承受500 N的轴向负荷：中立位、跖屈10度和背屈10度。在通过截骨术制造舌型骨折之前和之后测定负荷特征。使用电容式压力分布平台测量足底负荷模式。在引入距舟关节和跟骰关节的压敏膜上记录关节内接触面积和压力。跟骰关节负荷增加（+25%，p = 0.005）以及距舟关节负荷降低（-16%，p = 0.01）与足底外侧表面负荷增加相对应。这些发现与足部位置无关。结果表明，在跟骨骨折患者中观察到的足部外侧负荷增加的影响（Rosenbaum等人，《临床生物力学》10，345 - 351，1995）是由关节运动学变化引起的，似乎并非由损伤后形成的保护性步态模式导致。
