拇外翻致第一跖趾关节维持结构力学环境异常的应用基础研究

项目名称： 拇外翻致第一跖趾关节维持结构力学环境异常的应用基础研究

项目编号： No.81501931

项目类型： 青年科学基金项目

立项/批准年度： 2016

项目学科： 医药、卫生

项目作者： 李兵

作者单位： 同济大学

项目金额： 18万元

中文摘要： 拇外翻的治疗手段虽有百余种，但主要集中于不同截骨方法来矫正外形。由于忽视了更为重要的力学环境纠正，其术后并发症高达20%。故拇外翻足第一跖趾关节力学环境变化规律的研究有利于改进治疗方法，减少并发症。本课题组前期已对正常足第一跖趾关节的解剖和生物力学进行了研究，包括其维持韧带、肌腱的解剖学测量，三维活动度测量及籽骨的空间位置测定，并获取了相应的实验数据，为与畸形足比较提供了理论基础。本项目旨在通过解剖测量评估拇外翻足第一跖趾关节维持结构的解剖变异；通过三维坐标仪、电子压敏片等生物力学方法及有限元模型测试拇外翻足第一跖趾关节三维活动度、籽骨空间位置及关节内压力的异常变化，并与正常足比较，从而明确拇外翻足第一跖趾关节维持结构的解剖和生物力学病理变化特点，为其力学环境异常的病理生理学提供研究基础，以揭示其发病机制，为其预防和矫形支具的研发提供思路，并为治疗方法的改进及预后评估提供理论依据。

中文关键词： 拇外翻；跖趾关节；应力分析；三维重建

英文摘要： Though there are more than one hundred of treatment methods for hallux valgus, most of them focus on shape correction by different osteotomy of the first metatarsal. Due to ignoring the more important correction of the mechanical environment, postoperative complications of hallux valgus reach 20%. So the pathologic changes study of the first MTP can help to understand the abnormal of mechanical environment of hallux valgus, to improve treatment methods and reduce postoperative complications. Previous studies have been on the maintenance mechanism of the first MTP joint, including ligament and tendon anatomical study of the first MTP, measuring of three-dimensional motion and sesamoid motion, which helped us to abtain the mechanical parameters of the first MTP joint of normal foot and provided a theoretical basis for compare with foot with hallux valgus. The aims of this project are to evaluate the anatomic variations of the first MTP joint in hallux valgus feet with use of anatomical methods; and to measure the abnormal change of three-dimensional motion, sesamoid motion and joint pressure distribution of the first MTP joint with three-dimentional coordinatograph, electronic pressure sensitive film and finite element analysis methods, then comparing with normal foot, which can help to understand the pathologic changes of anatomy and biomechanics of the first MTP joint. This study is anticipated to provide research basis for hallux valgus pathophysiology, to elucidate the pathogenesis of the hallux valgus, to provide ideas for the prevention of hallux valgus and orthosis design, and to provide a basic theory for treatment options and prognosis evaluation.

英文关键词： hallux valgus;metatarsophalangeal joint;stress Analysis;three dimentional reconstruction