Effect of combined fibular osteotomy on the pressure of the tibiotalar and talofibular joints in supramalleolar osteotomy of the ankle: A cadaveric study : 사체 연구
족관절 과상부 절골술시 동반 비골 절골술이 경거골 및 거비골 관절 압력에 미치는 영향
- 주제(키워드) supramalleolar osteotomy , ankle joint , joint contact pressure , pressure sensor
- 발행기관 고려대학교 대학원
- 지도교수 이순혁
- 발행년도 2016
- 학위수여년월 2016. 2
- 학위구분 박사
- 학과 대학원 의학과
- 세부전공 정형외과학 전공
- 원문페이지 26 p
- 실제URI http://www.dcollection.net/handler/korea/000000065204
- 본문언어 영어
- 제출원본 000045875633
초록/요약
Purpose: The purpose of this study was to investigate the effect of combined fibular osteotomy on the pressure of the tibiotalar and talofibular joints in medial opening-wedge supramalleolar osteotomy of the ankle. Methods: Three different tibial osteotomy gaps (6, 8, and 10 mm) were created in 10 cadaveric models. An axial load of 700 N was applied, and pressure in the tibiotalar and talofibular joints was measured using a Tekscan pressure sensor before (Group A) and after (Group B) combined fibular osteotomy. Heel alignment angle (HAA) and talar translation ratio (TTR) were evaluated radiographically. Results: The contact and peak pressures in the tibiotalar joint were not affected by fibular osteotomy (p = 0.458 and p = 0.135) and tibial osteotomy gap size (p = 0.517 and p = 0.757) in the linear mixed model, whereas the contact and peak pressures in the talofibular joint decreased with fibular osteotomy (p < 0.001 and p = 0.001) and increased with increasing tibial osteotomy gap (p = 0.028 and p = 0.004). In the linear mixed model, the HAA decreased with increasing tibial osteotomy gap (p = 0.001) but was not affected by fibular osteotomy (p = 0.373). TTR decreased with fibular osteotomy (p = 0.010) and increasing tibial osteotomy gap (p = 0.017). Conclusion: In a medial opening-wedge supramalleolar osteotomy model, an increase in osteotomy gap led to increases in hindfoot valgus and pressure in the talofibular joint, while the tibiotalar joint pressure was not significantly changed with increasing osteotomy gap. A combined fibular osteotomy reduced the talofibular joint pressure increased after supramalleolar osteotomy, while it did not influence the tibiotalar joint pressure. We recommended a combined fibular osteotomy in medial opening-wedge supramalleolar osteotomy for medial ankle arthritis to minimize the increase of pressure in the talofibular joint, especially when the osteotomy gap is large.
more목차
Abstract ----------------------------------------------ii
1. Introduction ----------------------------------------1
2. Materials and Methods -------------------------------2
3. Results ---------------------------------------------5
4. Discussion ------------------------------------------7
5. Conclusion ------------------------------------------9
6. Reference -----------------------------------------10
