Mechanical behavior of the foot and ankle after plantar fascia release in the unstable foot

被引:50
作者
Kitaoka, HB
Luo, ZP
An, KN
机构
[1] MAYO CLIN & MAYO GRAD SCH MED, ROCHESTER, NY USA
[2] MAYO CLIN & MAYO FDN, DIV ORTHOPED RES, ROCHESTER, NY USA
关键词
D O I
10.1177/107110079701800103
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
The change in position of the bones of the foot was studied in three dimensions after plantar fascia release in intact and destabilized feet, Fifteen fresh-frozen human foot specimens were used. Physiologic loads of 445 newtons were applied axially to simulate standing at ease, and the three-dimensional position of tarsal bones was determined with a magnetic tracking device, The positions were presented in the form of screw axis displacements, quantitating rotation, and axis of rotation orientation, After fasciotomy in the six intact feet, significant differences in rotation were observed at the talotibial and calcaneotalar levels, After fasciotomy in the four unstable feet with three supporting elements sectioned, significant differences in position were observed at the talotibial joint and a significant decrease in arch height was observed, After fasciotomy in the five unstable feet with five supporting elements sectioned, significant differences in rotation were observed at the talotibial joint (mean, 5.5 +/- 1.6 degrees; P = 0.001), calcaneotalar joint (mean, 6.1 +/- 2.1 degrees; P = 0.003), and metatarsotalar level (mean, 9.3 +/- 4.1 degrees; P = 0.007), The average decrease in arch height was 7.4 +/- 4.1 mm (P = 0.015). Displacement of all joints tested occurred after fasciotomy, with rotation about all three axes, These changes in displacement were more pronounced in unstable or destabilized feet. The data suggest that operations involving fasciotomy affect arch stability and should not be performed in patients with evidence of concomitant pes planus deformity, because of the likelihood of further deformation.
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页码:8 / 15
页数:8
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