| 踝关节外侧副韧带损伤与距下关节软骨损伤相关性的有限元分析 |
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Received:July 24, 2024
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| 作者 | Author | 单位 | Unit | E-Mail |
| 张海洋 |
ZHANG Hai-yang |
哈尔滨医科大学附属第一医院骨科, 黑龙江 哈尔滨 150001 |
Department of Orthopaedics, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China |
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| 娄博 |
LOU Bo |
哈尔滨医科大学附属第一医院骨科, 黑龙江 哈尔滨 150001 |
Department of Orthopaedics, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China |
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| 刘政 |
LIU Zheng |
哈尔滨工业大学机电工程学院, 黑龙江 哈尔滨 150001 |
School of Mechanical and Electrical Engineering, Harbin Institute of Technology, Harbin 150001, Heilongjiang, China |
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| 朱哲 |
ZHU Zhe |
哈尔滨医科大学附属第一医院骨科, 黑龙江 哈尔滨 150001 |
Department of Orthopaedics, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China |
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| 王焕 |
WANG Huan |
哈尔滨医科大学附属第一医院骨科, 黑龙江 哈尔滨 150001 |
Department of Orthopaedics, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China |
503291201@qq.com |
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| 期刊信息：《中国骨伤》2025年38卷，第6期，第626-632页 |
| DOI：10.12200/j.issn.1003-0034.20230658 |
| 基金项目:2023年度黑龙江省卫生健康委科技计划(编号:20230404070193) |
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目的：建立不同踝关节外侧副韧带损伤的足踝模型,并对其进行有限元分析,探讨距下关节软骨在不同步态阶段及不同载荷下足内翻动作时的受力情况。
方法：选取1名30岁男性健康志愿者(身高175 cm,体重60 kg)的正常足踝CT,将其CT图像分别导入Mimics 21.0、Geomajic 2017、Solidworks 2017等软件,提取正常足踝骨骼模型,再于ANSYS 2021中构建不同踝关节外侧副韧带损伤的足踝有限元模型,分为距腓前韧带(anterior talofibular ligament,ATFL)断裂组,ATFL、跟腓韧带(calcaneo fibular ligament,CFL)断裂组,ATFL、CFL、距腓后韧带(posterior talofibular liga-ment,PTFL)断裂组,韧带功能完整的对照组。分别在胫骨、距骨上根据不同相位的受力情况,施加相应水平、竖直方向的载荷与扭矩,模拟行走步态中落地相、中立相和离地相。观察4组在落地相、中立相和离地相步态中距下关节软骨应力分布区域改变及应力峰值改变。模拟内翻扭伤动作,分别施加600、1 800、4 200 N的载荷,观察4组模型距下关节软骨的应力分布区域与应力峰值的变化情况。
结果：在步态模拟中,ATFL断裂组,ATFL、CFL断裂组,ATFL、CFL和PTFL断裂组,对照组落地相的应力结果分别为0.889 54、0.960 89、1.139 20、0.722 64 MPa。中立相应力结果分别为1.250 60、1.358 50、1.363 70、1.246 40 MPa;离地相应力结果分别为1.029 90、1.138 70、1.145 90、0.832 40 MPa。在内翻模拟中,ATFL断裂组,ATFL、CFL断裂组,ATFL、CFL和PTFL断裂组,对照组在600 N载荷下应力分别为2.191 3、2.208 5、2.215 7、2.156 6 MPa。1 800 N载荷下应力结果分别为7.134 7、9.715 2、10.064 0、7.107 0 MPa;4 200 N载荷下应力分别为17.435 0、25.309 0、26.119 0、16.010 0 MPa。
结论：踝关节外侧副韧带对距下关节的稳定性有重要作用,尤其是CFL在限制跟骨内翻的过程中起着重要作用。若损伤这些韧带,会造成距下关节不稳,使距下关节软骨发生病变,应该减少相关运动或及时治疗韧带损伤。 |
| [关键词]:踝关节 外侧副韧带 距下关节 软骨损伤 有限元分析 |
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| Finite element analysis of the correlation between lateral collateral ligament injury of the ankle joint and subtalar articular cartilage injury |
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Abstract:
Objective To establish foot and ankle models of different lateral collateral ligament injuries of ankle joint,and conduct finite element analysis on,and to explore the force conditions of subtalar articular cartilage during foot inversion movements under different gait stages and under different loads.
Methods A normal ankle CT scan of a 30-year-old male healthy volunteer (heighted 175 cm and weighted 60 kg) was selected. The CT images were imported into software such as Mimics 21.0,Geomajic 2017,and Solidworks 2017 respectively,extract the normal ankle bone model. Then,the foot and ankle finite element models of different lateral collateral ligament injuries of ankle joint were constructed and divided into anterior talofibular ligament (ATFL) rupture group,ATFL and calcaneo fibular ligament (CFL) rupture group,ATFL,CFL and posterior talofibular ligament (PTFL) rupture group,and control group with intact ligament function by ANSYS 2021. Corresponding horizontal and vertical loads and torques were applied respectively on tibia and talus according to the force conditions of different phases to simulate landing phase,neutral and off-ground phase in walking gait. The changes in stress distribution area and stress peak of subtalar articular cartilage in the loading phase,neutral phase and off-ground phase gaits among four groups were observed. Simulate varus sprain action,apply different loads of 600,1,800,and 4,200 N respectively,and changes in stress distribution area and the stress peak of subtalar articular cartilage among four groups of models were observed.
Results In the gait simulation,the stress results of loading phase in ATFL fracture group,ATFL and CFL fracture groups,ATFL,CFL and PTFL fracture groups,and control group were 0.889 54,0.960 89,1.139 20,and 0.722 64 MPa,respectively. The neutral response force results were 1.250 60,1.358 50,1.363 70,1.246 40 MPa respectively;the results of corresponding forces off-ground phase were 1.029 90,1.138 70,1.145 90 and 0.832 40 MPa respectively. In the inversion simulation,the stresses of ATFL fracture group, ATFL and CFL fracture groups,ATFL,CFL and PTFL fracture groups,and control group under load of 600 N were 2.191 3, 2.208 5,2.215 7,and 2.156 6 MPa respectively. The stresses under a load of 1 800 N were 7.134 7,9.715 2,10.064 0,and 7.107 0 MPa respectively;the stresses under a load of 4 200 N were 17.435 0,25.309 0,26.119 0 and 16.010 0 MPa respectively.
Conclusion The lateral collateral ligament of ankle joint plays an important role in the stability of the subtalar joint,especially CFL plays an important role in restricting calcaneal varus. If these ligaments are damaged,it will cause instability of the subtalar joint and further lead to lesions in the subtalar articular cartilage. Relevant exercises should be reduced or the ligament injuries should be treated in a timely manner. |
| KEYWORDS:Ankle joint Lateral collateral ligament Subtalar joint Cartilage injury Finite element analysis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张海洋,娄博,刘政,朱哲,王焕.踝关节外侧副韧带损伤与距下关节软骨损伤相关性的有限元分析[J].中国骨伤,2025,38(6):626~632 |
| 英文格式: | ZHANG Hai-yang,LOU Bo,LIU Zheng,ZHU Zhe,WANG Huan.Finite element analysis of the correlation between lateral collateral ligament injury of the ankle joint and subtalar articular cartilage injury[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(6):626~632 |
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