Objective To Investigate The Effect Of "Jin Shu Gu" On Osteochondral Injury Of Talus

Objective:Based on the traditional"Jin shu gu"theory,through the finite element modeling method to study the mechanical relationship between the lateral instability of ankle joint and talus osteochondral injury,to explore the correlation between the lower tibiofibular syndesmosis and lateral collateral ligament to maintain the stability of ankle joint,through the finite element simulation technology to verify the modern feasibility and applicability of the traditional"tendon bone"theory,to provide reference for the clinical treatment of tendon diseases thinking.Methods:A 29 year old healthy adult male volunteer was selected.64 slice spiral CT of the right lower limb was taken with a slice thickness of 0.6 mm.1007 images were obtained and imported into mimics 16.0 and Geomagic The 3D solid model of ankle joint was completed by image processing in studio2014software MSC.Patran/Nastran2012 Software to establish cartilage,tendon and other ankle bone appendages,and mesh the model to complete the establishment of ankle joint fine finite element model.In this study,four finite element models of different degrees of ligament complex injury(blank group with ligament preserved,lateral collateral ligament complex injury group,lower tibiofibular syndesmosis complex injury group,lateral collateral ligament complex and lower tibiofibular syndesmosis complex injury group at the same time)were established The pressure area,equivalent stress and displacement of talus under vertical load were measured.Results:1.In the simulated anterior drawer test,with the gradual increase of forward traction,the equivalent force,equivalent stress and displacement of the talus in each group also increased.The equivalent force and equivalent stress of the talus increased relatively fast between 40N and 100N of forward traction.After 100N,the increase of the stress of the talus decreased,and the displacement of the talus was between 40N and 100N of forward traction After100N,the pressure area of the tibiotalar joint in the blank group decreased slowly,while the pressure area of the tibiotalar joint in the other three ligament injury groups still decreased significantly.After 100N,the pressure area of the tibiotalar joint in the lower tibiofibular complex injury group,the lateral collateral ligament complex injury group,the lower tibiofibular complex and the lateral collateral ligament injury group decreased significantly The area of tibiotalar joint pressure in the complex injury group was smaller than that in the blank group;2.In the simulated varus stress test,the equivalent stress of the tibiotalar joint surface in each group was about 12.3Mpa-16.0Mpa,in which the equivalent stress of the tibiotalar joint surface in the lower tibiofibular complex injury group was the largest and the blank group was the smallest;the equivalent stress of the talus in each group was about 22.0Mpa-25.2Mpa,in which the equivalent stress of the lower tibiofibular complex and the lateral collateral ligament complex injury group was the largest and the blank group was the smallest;the equivalent stress of the tibiotalar joint surface in each group was about 22.0Mpa-25.2Mpa The force area was about368.5mm~2-453.2mm~2.Compared with the blank group,the pressure area of the other injury groups was decreased,and the lower tibiofibular syndesmosis injury group had the largest decrease,about-18.7%;the talus displacement of each group was about 6.75mm-8.46mm.Compared with the blank group,the talus displacement of the other injury groups was increased,including the lower tibiofibular syndesmosis and lateral accessory malleolus 3%,the largest increase was about 25%.3.In the simulated external rotation stress test,the equivalent stress of tibial talus joint surface in each group was about 12.4Mpa-19.5Mpa,and the equivalent stress of talus in each group was about 23.6Mpa-37.3Mpa,in which the maximum was in the combined injury group of lower tibiofibular syndesmosis and lateral collateral ligament complex,and the minimum was in the blank group;the pressure area of tibial talus joint surface in each group was about 368.1mm~2-431.6mm~2,which was relative to the blank group,and the corresponding tibial talus joint area in the other injury groups Compared with the blank group,the talus displacement of the other injury groups increased,and the increase of the talus displacement of the lower tibiofibular syndesmosis complex and lateral collateral ligament complex injury group was the largest,about 59 6%。.Conclusion:1.The tibiofibular syndesmosis complex and the lateral collateral ligament complex maintain the biomechanical stability of the ankle joint by limiting the displacement of the talus,reducing the stress on the tibiotalar joint surface and the equivalent stress of the talus.2.Lateral collateral ligament complex injury is more prone to ankle instability,loss of talus stability and ankle balance,leading to talus osteochondral injury.3.Modern orthopedics treatment of talus osteochondral injury should follow the traditional Chinese medicine"tendon bone"principle,through the repair of ankle lateral collateral ligament complex and lower tibiofibular syndesmosis complex,redistribute the mechanical stress on the surface of talus cartilage,so as to delay the progress of talus osteochondral injury.