KINEMATICS AND STABILITY OF THE ARCH OF THE FOOT

足弓的运动学和稳定性

• 批准号: 6171306
• 负责人: HAROLD B KITAOKA
• 金额: $ 12.2万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-01 至 2002-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6171306
• 关键词: ankle; arthrodesis; biomechanics; clinical research; elasticity; evaluation /testing; foot; gait; human tissue; joint ligament; mechanical pressure; orthopedics; skeletal disorder; skeletal stress; statistics /biometry; tendons; tibia

The arch of the foot is important in performing activities to provide a stable base for weight bearing, flexibility to accommodate different ground conditions, and also to dissipate loads from weight bearing. The arch is constrained by bony and articular geometry, ligaments, joint capsules, and fascia. Posterior tibial tendon dysfunction (PTTD) is associated with loss of these constraints, leading to pain, impaired function, and flatfoot deformity. This study will focus upon four specific aims related to function of the arch and to mechanical behavior of the foot with orthoses or reconstruction procedures for PTTD and flatfoot. Hypothesis 1: Normal gait may be observed in vitro with a dynamic ankle simulator. Specific Aim 1: To determine foot and ankle kinematics, ground reaction force, and center of pressure advancement in level walking in normals. Hypothesis 2: Posterior tibial tendon dysfunction and flatfoot are associated with markedly abnormal foot and ankle kinematics, ground reaction force, and center of pressure advancement in level walking. Specific Aim 2: To determine foot and ankle kinematics in cadaveric feet with simulated posterior tibial tendon dysfunction and flatfoot and compare results with normals. Hypothesis 3: Hindfoot orthoses (HFO) improve foot and ankle function in feet with posterior tibial tendon dysfunction and flatfoot on level walking. Specific Aim 3: To evaluate mechanical behavior of the foot and ankle with posterior tibial tendon dysfunction and flatfoot treated with articulated and nonarticulated HFO on level walking. Hypothesis 4: Reconstruction operations for posterior tibial tendon dysfunction and flatfoot which do not involve extensive arthrodesis improve foot and ankle function in level walking. Specific Aim 4: To evaluate mechanical behavior of the foot and ankle with three recently developed and yet to be proven operations for posterior tibial tendon dysfunction and flatfoot: lateral column lengthening (LCL), medial displacement calcaneal osteotomy (MDO), and Giannini subtalar implant.

足弓在进行活动时非常重要，它可以为承重提供稳定的基础、适应不同地面条件的灵活性以及分散承重负荷。 足弓受到骨和关节几何形状、韧带、关节囊和筋膜的约束。胫骨后肌腱功能障碍 (PTTD) 与这些约束的丧失有关，导致疼痛、功能受损和扁平足畸形。 这项研究将重点关注与足弓功能和足部机械行为相关的四个具体目标，包括矫形器或 PTTD 和平足重建手术。假设1：可以使用动态踝模拟器在体外观察正常步态。 具体目标 1：确定正常水平行走时足部和踝部运动学、地面反作用力和压力中心前进。 假设2：胫骨后肌腱功能障碍和扁平足与水平行走时足部和踝部运动学、地面反作用力和压力中心前移的明显异常有关。具体目标 2：确定具有模拟胫骨后肌腱功能障碍和扁平足的尸体足部的足部和踝部运动学，并将结果与​​正常情况进行比较。 假设 3：后足矫形器 (HFO) 可改善胫后肌腱功能障碍和平足的足部和踝部功能。 具体目标 3：评估采用铰接式和非铰接式 HFO 治疗的胫骨后肌腱功能障碍和平足患者在水平行走时足部和踝部的机械行为。 假设 4：胫骨后肌腱功能障碍和扁平足的重建手术不涉及广泛的关节融合术，可改善足部和踝关节的水平行走功能。 具体目标 4：通过三种最近开发但尚未证实的治疗胫骨后肌腱功能障碍和扁平足的手术来评估足部和踝部的机械行为：外侧柱延长术 (LCL)、内侧移位跟骨截骨术 (MDO) 和 Giannini 距下植入物。