中足重建纠正可复性平足症力学环境的应用基础研究

项目名称： 中足重建纠正可复性平足症力学环境的应用基础研究

项目编号： No.81472144

项目类型： 面上项目

立项/批准年度： 2015

项目学科： 医药、卫生

项目作者： 杨云峰

作者单位： 同济大学

项目金额： 72万元

中文摘要： 可复性平足症为平足畸形发展的中期阶段，也是治疗上的重点和难点。为防止疾病进展到足踝关节僵硬的终末期，多采用手术方式进行干预。传统的肌腱转位和关节融合以牺牲正常软组织和骨性结构为代价以期达到缓解疼痛，改善畸形的目的，手术创伤大，并使足部处于非生理状态，有较高并发症。近年来，根据可复性平足症的解剖特点、国外少量报道和我们的临床工作发现，通过胫后肌腱的止点重建、足底韧带加强并结合中足骨性结构的整合等中足重建的方法，能获得较好的临床疗效，并最大限度保留足部关节功能。中足重建将会是可复性平足症治疗上的一个突破口，但目前仍缺乏基础研究的有力支持。本课拟在前期研究的基础上，通过生物力学、医学影像学和临床实践，研究中足的生物力学特点，明确中足重建在平足症治疗中的作用和意义。探讨科学合理的中足重建策略和手术方法，对临床合理治疗可复性平足症提供理论依据，以提高临床近期和远期疗效，节约医疗资源。

中文关键词： 平足症；截骨矫形；手术治疗；应力分析；有限元分析

英文摘要： The treatment of flexible flat foot which is the middle stage of adult acquire flatfoot deformity is the key point and a challenge to both the surgeons and patients. Surgical intervention is necessary to correct the resulting deformity and restore function of the limb by avoiding late rigid stage. Tendon transfer and joint fusion are used to release pain and modify foot appearance that means some physical structures are sacrificed. Most of the traditional treatment methods will lead the foot into a non-physiological state, and various complications are common. In recent years, according to some foreign reports and our clinical work, we found that the founctional reconstruction of the midfoot play a crucial role in the treatment and prognosis of flexible flatfoot, such as posterior tibial tendon reconstruction, plantar ligaments augmentation and bony structure realignment. Midfoot reconstruction will be the key stone to the treatment of flexible flat foot. However, few research focus on the biomechanical characteristics of the midfoot in flexibile flatfoot and how it works in the surgical correction. Based on our prior research, The aims of this project is to analyze the biomechanical characteristics of the midfoot and explore reasonable methods to correct and restore normal function of flexible flat foot, thus, to clear the role and significance of midfoot reconstruction in the flatfoot. So as to improve the efficacy and long term outcomes of the surgical treatment in flexible flat foot and save medical resources and costs.

英文关键词： flat foot;osteotomy;surgical therapy;stress analyze;finite element analysis