有限元法分析腓骨瓣重建完全缺失跟骨的生物力学.

BACKGROUND: Calcaneal defects are common in clinical practice. It is difficult for surgeons to evaluate the effect of calcaneal reconstruction due to the complex anatomical structure and motor function of the heel. Finite element analysis has become an effective method for biomechanical behavior simulation and numerical analysis. OBJECTIVE: To compare the clinical effect and biomechanical characteristics of total calcaneal reconstruction with the II-shaped and V-shaped fibular flap. METHODS: CT images of one left foot of a healthy 50-year-old male were acquired. Mimics software was used to obtain the preliminary three-dimensional model. Geomagic software was used to trim and curve the model. The model was imported into Solidworks software to simulate calcaneal reconstruction and complete the pre-processing of finite element calculation. Finally, Ansys software was used to solve the problem. The simulation results were compared with previous literature results to verify the effectiveness of the model. The surgical effect and biomechanical characteristics of the foot in different gait phases based on the simulated stress results were analyzed. RESULTS AND CONCLUSION: (1) Both II-shaped and V-shaped fibular flaps could be used to reconstruct completely missing calcaneus, which could restore the length, width and height of normal calcaneus, and fill up the missing calcaneus bone. (2) Compared with the normal calcaneus, both configurations of fibular flaps showed a tendency for over-concentration of stress after loading. The normal calcaneus stress was mostly concentrated around the calcaneus nodule, the subtalar process and the calcaneus groove, while the stress of the two fibular flaps was mostly concentrated at the junction between the bone flap with the talus and cuboid bones. (3) The maximum stress of calcaneus was different between the two models and normal calcaneus under different simulation conditions, with statistically significant differences (P < 0.05). Compared with the V-shaped fibular flaps, II-shaped fibular flaps had less force change in different gaits and were closer to the normal calcaneus. The V-shaped fibular flap bore excessive stress during the period of push-off, and the grafted bone material may yield under this condition and have the risk of fractures. [ABSTRACT FROM AUTHOR]