Chinese Journal of Tissue Engineering Research ›› 2016, Vol. 20 ›› Issue (46): 6899-6906.doi: 10.3969/j.issn.2095-4344.2016.46.008

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Relationship between ankle-hind foot function and calcaneal three-dimensional morphological parameters

Xu Can, Li Ming-qing, Li Kang-hua, Liu Hua   

  1. Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
  • Received:2016-09-07 Online:2016-11-11 Published:2016-11-11
  • Contact: Liu Hua, M.D., Associate chief physician, Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
  • About author:Xu Can, M.D., Attending physician, Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
  • Supported by:

     the National Natural Science Foundation for the Youth of China, No. 81301543

Abstract:

BACKGROUND: Both the overall appearance of the calcaneus and anatomical reduction of posterior subtalar joint are important prognostic factors of calcaneal intra-articular fracture repair. However, there is a lack of biomechanical data supporting the clinical importance of calcaneus height, length and heel width for the ankle-hind foot function.
OBJECTIVE: To determine the correlation of the three-dimensional morphological parameters with the ankle-hind foot biomechanics as determined by the entity experiment and numerical analysis.
METHODS: Models of abnormal calcaneus height, length and width were constructed in the human cadaveric feet and underwent a biomechanical load. The kinematics of the ankle-hind foot were compared between normal and simulated calcaneal fractures with reductions in calcaneal height and length as well as increases in calcaneal width. In finite element analysis, static loading was simulated at an axial load with the subtalar joint in a neutral position, and the effects of the injured calcaneus on the contact characteristics of the subtalar joints were evaluated in terms of contact areas, peak contact pressures and pressure distributions.
RESULTS AND CONCLUSION: The increase in calcaneal width somewhat limited the subtalar motion, and the reduction in length mainly limited the external rotation and plantar flexion of the subtalar joint. However, the reduction in height mainly resulted in the subtalar rotatory instability. The increase in width broadened the contact area but more notably increased the high pressure contact zone. With height loss, the overall contact area decreased, and the contact pressure center shifted to the anteroinferior portion of articulation. In conclusion, the normal biomechanics of the ankle-hind foot are severely disrupted by the abnormal calcaneus morphology. Therefore, the three-dimensional calcaneus morphology must be carefully restored in the treatment of calcaneus fractures.

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松组织工程

Key words: Calcaneus, Fractures, Bone, Biomechanics, Finite Element Analysis, Tissue Engineering

CLC Number: