不同康复训练方法对术后拇外翻第1跖列的生物力学影响

目的 研究拇外翻术后不同康复训练对第1跖列的生物力学影响。方法 通过拇外翻医学影像数据建立完整的足部三维有限元模型，此模型包括骨骼、籽骨、软骨、韧带、软组织、跟腱等结构。模拟分析拇外翻患者术后被动跖屈和背屈、主动跖屈和背屈、站立位对截骨远端的生物力学影响。结果 被动训练情况下，截骨远端截骨面的应力分布较均匀，且峰值（7.78 MPa）较站立位和主动训练时大；被动训练时的最大位移量（0.98 mm）在前后方向上大于站立位（0.69 mm）和主动训练（0.38 mm）的位移量。结论 被动训练可促进截骨面的接触，并减少截骨端的愈合时间，有利于术后拇外翻患者的康复。
Objective To investigate the effect of the different rehabilitation training method on the first ray of postoperative hallux valgus (HV). Methods Based on medical images of HV patient, a comprehensive three-dimensional finite element model of HV foot was established, including bones, sesamoid, cartilage, ligaments, soft tissues, Achilles tendon. The passive/active plantar flexion and dorsal flexion as well as standing were simulated to investigate the biomechanical behavior of distal osteotomy fragment of the postoperative HV. Results The stress distribution on distal osteotomy fragment during passive training was more uniform, and the peak stress (7.78 MPa) was greater than that during stance phase and active training. The distal osteotomy fragment displacement during passive training (0.98 mm) in anterior-posterior direction was greater than that during stance phase (0.69 mm) and active training (0.38 mm). Conclusions The passive training could promote the contact of osteotomy surface and reduce the healing time of osteotomy, which would be beneficial for rehabilitation of postoperative HV.