不确定环境导致踝关节外侧韧带随机损伤的生物力学机制研究

The lateral ligament injury of ankle joint is one of most common injury, the research on injury mechanism and risk factors of the lateral ligament of ankle joint is the main way to decrease and prevent the ankle joint injuries. The main purpose of research is to investigate the injury mechanism of lateral ligament of ankle joint due to uncertain environment from the angle of math and mechanics, according to the kinematics, dynamics(plantar force and ground reaction force), electromyography and finite element method, the biomechanical characteristic of ankle joint and risk factors of the lateral ligament of ankle joint are analyzed about motion partterns under the uncertain environment, the relation of motion partterns and mechanics characteristic of the lateral ligament under uncertain enviroment is studied. The stochasti biomechanical model of the lateral ligament of ankle joint is established based on Monte-Carlo, the biomechanical quantitative evaluation of the risk factors of the lateral ligament of ankle joint is carried out, and then the probability of lateral ligament injury and risk factors of ankle joint are ascertained, the stochastic biomechanics study of the lateral ligament injury of ankle joint for healthy people under uncertain environment is developed. This study provides theory basis to reveal the mechanism of the lateral ligament injury of ankle joint, decrease and prevent the injury of ankle joint.

踝关节外侧韧带损伤是常见的运动损伤之一，对其损伤的生物力学机制和致伤危险因素的研究，是预防和减少损伤的重要手段。本研究从数学力学角度探究不确定环境导致踝关节外侧韧带随机损伤的生物力学机制，模拟不确定环境中多种运动模式情境，将运动学、动力学（足底压力与足底反力）、肌电学与有限元理论相结合，对多种运动模式下踝关节的运动生物力学特征以及踝关节外侧韧带致伤因素进行综合分析，进一步探索不确定环境下不同运动模式与受力特点之间的关系。基于Monte-Carlo随机方法，建立踝关节外侧韧带受力的随机生物力学模型,对其致伤危险因素进行生物力学定量化评价，确定踝关节外侧韧带损伤的概率以及危险因素，开展无损条件下不确定环境导致踝关节外侧韧带损伤的随机生物力学研究。为全面揭示踝关节外侧韧带损伤的发生机制，减少和预防踝关节损伤的发生提供理论依据。

踝关节是人体重要承重关节及运动枢纽，容易受到损伤，而其损伤又以外侧韧带损伤最为常见，因此其损伤机制及致伤危险因素的研究，是预防和减少损伤的重要手段。本研究从力学角度探究不确定环境导致踝关节外侧韧带随机损伤的生物力学机制，基于Monte-Carlo随机方法对踝关节外侧韧带损伤进行力学定量化评价这一独特视角，模拟不确定环境中多种运动模式情境，将运动学、动力学（足底压力与足底反力）与有限元理论相结合，对多种运动模式下踝关节的运动生物力学特征以及踝关节外侧韧带致伤因素进行综合分析，不确定环境下踝关节外侧副韧带损伤者患侧、健侧踝关节跖屈力矩的最大值小于正常者，其值分别为：-1.395±0.218 Nm/Kg、-1.251±0.208 Nm/Kg。患侧背屈力矩小于健康者，其力矩最大值为：0.056±0.015 Nm/Kg，健侧背屈力矩大于正常者，其力矩最大值为0.082±0.007 Nm/Kg。患侧、健侧踝关节外翻力矩的最大值大于正常者，最大值分别为：0.194±0.028Nm/Kg，0.157±0.067Nm/Kg。患侧内翻力矩大于健康者，其最大值为：-0.089±0.015Nm/Kg；健侧踝关节内翻力矩小与正常者，其最大值为：-0.050±0.016 Nm/Kg，与健康者相比，损伤者健侧内旋力矩、外旋力矩明显偏小，其最大内旋力矩为：0.068±0.028 Nm/Kg，最大外旋力矩为：0.068±0.012 Nm/Kg；患侧只产生一个内旋力矩，最大力矩值为：0.101±0.031 Nm/Kg，患侧外旋力矩比自身健侧与健康者的大很多，最大值为0.322±0.0762Nm/Kg。建立踝关节外侧韧带受力的随机生物力学模型，导出踝关节外侧韧带损伤的概率以及危险因素，开展无损条件下不确定环境导致踝关节外侧韧带损伤的随机生物力学研究。确定危险因素主要有：性别对踝关节损伤概率的影响、损伤和未损伤模拟间的差异、踝关节内旋和外旋角度对韧带负荷的影响、地面反作用力对踝关节外侧韧带损伤的影响、踝关节关节屈角对韧带损伤的影响、着地方式对踝关节外侧韧带损伤的影响、踝关节内翻和外翻角度对韧带负荷的影响等。通过探索不确定环境下不同运动模式与受力特点之间的关系，揭示踝关节外侧韧带损伤的发生机制，为减少和预防踝关节损伤的发生提供理论依据。