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首页> 外文期刊>Journal of orthopaedic research >Patient specific computational models to optimize surgical correction for flatfoot deformity
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Patient specific computational models to optimize surgical correction for flatfoot deformity

机译：患者特定的计算模型，优化Flatfoot畸形的手术校正

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Several surgically corrective procedures are considered to treat Adult Acquired Flatfoot Deformity (AAFD) patients, relieve pain, and restore function. Procedure selection is based on best practices and surgeon preference. Recent research created patient specific models of AAFD to explore their predictive capabilities and examine effectiveness of the surgical procedure used to treat the deformity. The models' behavior was governed solely by patient bodyweight, soft tissue constraints, muscle loading, and joint contact without the assumption of idealized joints. The current work expanded those models to determine if an alternate procedure would be more effective for the individual. All procedures incorporated first a tendon transfer and then included one hindfoot procedure, the Medializing Calcaneal Osteotomy (MCO), and one of three lateral column procedures: Evans osteotomy, Calcaneocuboid Distraction Arthrodesis (CCDA), Z osteotomy, and the combination procedures MCO & Evans osteotomy, MCO & CCDA, and MCO & Z osteotomy. The combination MCO & Evans and MCO & Z procedures were shown to provide the greatest amount of correction for both forefoot abduction and hindfoot valgus. However, these two procedures significantly increased joint contact force, specifically at the calcaneocuboid joint, and ground reaction force along the lateral column. With exception to the lateral bands of the plantar fascia and middle spring ligament, the strain present in the plantar fascia, spring, and deltoid ligaments decreased after all procedures. The use of patient specific computational models provided the ability to investigate effects of alternate surgical corrections on restoring biomechanical function in these flatfoot patients. (c) 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1523-1531, 2017.
机译：几种手术矫正程序被认为是治疗成人获得的Flatfoot畸形（AAFD）患者，缓解疼痛和恢复功能。程序选择是基于最佳实践和外科医生偏好。最近的研究创造了AAFD的患者特定模型，探讨了他们的预测能力，并检查用于治疗畸形的外科手术的有效性。模型的行为仅由患者体重，软组织限制，肌肉加载和关节接触而定于理想化关节的情况。目前的工作扩展了这些模型来确定备用程序是否对个体更有效。所有程序掺入了第一种肌腱转移，然后包括一个后脚手术，中血管性转化截骨术（MCO），以及三个侧柱手术中的一种：evans骨质切除术，钙化吡吡吡吡吡吡吡吡吡吡吡吡螺旋关节瘤（CCDA），Z截错术和组合程序MCO和EVANS骨质型，MCO＆CCDA和MCO＆Z骨质图。显示MCO和evans和MCO＆Z程序的组合为前脚绑架和Hindfoot Valgus提供了最大的校正。然而，这两种方法显着增加了关节接触力，特别是在煅烧吡替替突接头处，以及沿着侧柱的接地反作用力。对于跖筋和中间弹簧韧带的横向条带，底特尔筋膜，弹簧和三角肌韧带存在的菌株在所有程序之后降低。使用患者特异性计算模型提供了调查替代手术校正对这些FlateFoot患者恢复生物力学功能的影响的能力。 （c）2016骨科研究会。由Wiley期刊出版，Inc.J Orthop Res 35：1523-1531,2017。

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