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Impact of first metatarsal shortening on forefoot loading pattern: a finite element model study.
BMC Musculoskeletal Disorders ( IF 2.2 ) Pub Date : 2019-12-27 , DOI: 10.1186/s12891-019-2973-6
Xiang Geng 1 , Jiaqi Shi 1 , Wenming Chen 2, 3 , Xin Ma 1 , Xu Wang 1 , Chao Zhang 1 , Li Chen 1
Affiliation  

BACKGROUNDS There has long been a consensus that shortening of the first metatarsal during hallux valgus reconstruction could lead to postoperative transfer metatarsalgia. However, appropriate shortening is sometimes beneficial for correcting severe deformities or relieving stiff joints. This study is to investigate, from the biomechanical perspective, whether and how much shortening of the first metatarsal could be allowed. METHODS A finite element model of the human foot simulating the push-off phase of the gait was established. Progressive shortening of the first metatarsal from 2 to 8 mm at an increment of 2 mm were sequentially applied to the model, and the corresponding changes in forefoot loading pattern during push-off phase, especially the loading ratio at the central rays, was calculated. The effect of depressing the first metatarsal head was also investigated. RESULTS With increasing shortening level of the first metatarsal, the plantar pressure of the first ray decreased, while that of the lateral rays continued to rise. When the shortening reaches 6 mm, the load ratio of the central rays exceeds a critical threshold of 55%, which was considered risky; but it could still be manipulated to normal if the distal end of the first metatarsal displaced to the plantar side by 3 mm. CONCLUSIONS During the first metatarsal osteotomy, a maximum of 6 mm shortening length is considered to be within the safe range. Whenever a higher level of shortening is necessary, pushing down the distal metatarsal segment could be a compensatory procedure to maintain normal plantar force distributions.

中文翻译:

第一meta骨缩短对前脚负荷模式的影响:有限元模型研究。

背景长期以来,人们一直认为,拇趾外翻重建过程中第一meta骨的缩短会导致术后转移meta骨痛。但是,适当的缩短有时对于纠正严重的畸形或缓解僵硬的关节是有益的。这项研究是从生物力学的角度来研究是否可以以及允许第一meta骨缩短的程度。方法建立人脚模拟步态下垂阶段的有限元模型。将第一meta骨以2 mm的增量从2 mm逐渐缩短到8 mm,并计算下推阶段前脚的负荷模式的相应变化,尤其是中央射线的负荷率。还研究了压下第一meta骨头的效果。结果随着第一meta骨缩短水平的增加,第一骨的足底压力降低,而侧rays骨的足底压力持续升高。当缩短量达到6 mm时,中央光线的负载率超过了55%的临界阈值,这被认为是有风险的;但如果第一meta骨的远端向to侧偏移3 mm,仍可以正常操作。结论在第一次meta骨截骨术中,最大长度缩短6 mm被认为在安全范围内。每当需要更高水平的缩短时,将meta骨远端向下推可能是一种补偿程序,以维持正常的足底肌力分布。结果随着第一meta骨缩短水平的增加,第一骨的足底压力降低,而侧rays骨的足底压力持续升高。当缩短量达到6 mm时,中央光线的负载率超过了55%的临界阈值,这被认为是有风险的;但如果第一meta骨的远端向to侧偏移3 mm,仍可以正常操作。结论在第一次meta骨截骨术中,最大长度缩短6 mm被认为是在安全范围内。每当需要更高水平的缩短时,将meta骨远端向下推可能是一种补偿程序,以维持正常的足底肌力分布。结果随着第一meta骨缩短水平的增加,第一骨的足底压力降低,而侧rays骨的足底压力持续升高。当缩短量达到6 mm时,中央光线的负载率超过了55%的临界阈值,这被认为是有风险的;但如果第一meta骨的远端向to侧偏移3 mm,仍可以正常操作。结论在第一次meta骨截骨术中,最大长度缩短6 mm被认为是在安全范围内。每当需要更高水平的缩短时,将meta骨远端向下推可能是一种补偿程序,以维持正常的足底肌力分布。而侧面射线的射线继续上升。当缩短量达到6 mm时,中央光线的负载率超过了55%的临界阈值,这被认为是有风险的;但如果第一meta骨的远端向to侧偏移3 mm,仍可以正常操作。结论在第一次meta骨截骨术中,最大长度缩短6 mm被认为在安全范围内。每当需要更高水平的缩短时,将meta骨远端向下推可能是一种补偿程序,以维持正常的足底肌力分布。而侧面射线的射线继续上升。当缩短量达到6 mm时,中央光线的负载率超过了55%的临界阈值,这被认为是有风险的;但如果第一meta骨的远端向to侧偏移3 mm,仍可以正常操作。结论在第一次meta骨截骨术中,最大长度缩短6 mm被认为在安全范围内。每当需要更高水平的缩短时,将meta骨远端向下推可能是一种补偿程序,以维持正常的足底肌力分布。但如果第一meta骨的远端向to侧偏移3 mm,仍可以正常操作。结论在第一次meta骨截骨术中,最大长度缩短6 mm被认为是在安全范围内。每当需要更高水平的缩短时,将meta骨远端向下推可能是一种补偿程序,以维持正常的足底肌力分布。但如果第一meta骨的远端向to侧偏移3 mm,仍可以正常操作。结论在第一次meta骨截骨术中,最大长度缩短6 mm被认为是在安全范围内。每当需要更高水平的缩短时,将meta骨远端向下推可能是一种补偿程序,以维持正常的足底肌力分布。
更新日期:2019-12-27
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