An ex vivo sequential ligament transection model of flatfoot

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2024-08-01 DOI:10.1016/j.clinbiomech.2024.106302

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引用次数: 0

Abstract

Background

The ligaments implicated in the earliest stages of developing a progressive collapsing foot deformity are poorly understood. Commonly employed cadaveric flatfoot models are created from simultaneous transection of multiple ligaments, making it difficult to assess early changes in pressure distribution from ligaments critical for maintaining load distribution. A serial transection of ligaments may provide insight into changes in pressure distribution under the foot to identify a potential combination of ligaments that may be involved in early deformities.

Methods

Specimens were loaded using a custom designed axial and tendon loading system. Plantar pressure data for the forefoot and hindfoot were recorded before and after six sequential ligament complex transections.

Findings

Sectioning the plantar fascia (first) and short/long plantar ligaments (second) failed to generate appreciable differences in load distribution. Dividing the spring ligament (third) led to changes in hindfoot load distribution with a shift towards the lateral column indicative of hindfoot valgus angulation. All subsequent conditions resulted in similar patterns in hindfoot plantar load distribution. An anterior shift in the center of pressure only occurred after transection of all six ligament complexes.

Interpretation

Loss of the plantar fascia and short/long plantar ligaments are not critical in maintaining plantar load distribution or contact area. However, the additional loss of the spring ligament caused notable changes in hindfoot load distribution, indicating the combination of these three ligament complexes is particularly critical for preventing peritalar subluxation. Minimal changes in load distribution occurred when performing additional transections to reach a complete flatfoot deformity.

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扁平足的体外顺序韧带横切模型

背景人们对韧带在足部渐进性塌陷畸形早期发展过程中的作用知之甚少。常用的尸体扁平足模型是通过同时横断多条韧带制作的，因此很难评估对维持负荷分布至关重要的韧带压力分布的早期变化。对韧带进行连续横断可深入了解足底压力分布的变化，从而确定可能参与早期畸形的潜在韧带组合。研究结果对足底筋膜（第一次）和短/长足底韧带（第二次）进行横切并不能产生明显的负荷分布差异。分割弹簧韧带（第三次）导致后足负荷分布发生变化，向外侧柱移动，表明后足外翻成角。随后的所有条件都导致了类似的后足跖部负荷分布模式。解释足底筋膜和短/长足底韧带的缺失对于维持足底负荷分布或接触面积并不重要。然而，弹簧韧带的额外损失会导致后足负重分布发生显著变化，这表明这三种韧带复合物的结合对于预防跖周脱位尤为重要。在进行额外横断以达到完全平足畸形时，负荷分布的变化极小。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.