[3-D finite element and clinical analyses of the reconstruction of the first to third metatarsus defect with ilium].
OBJECTIVE
To investigate the effect of first to third metatarsus defect and the effect of reconstruction with ilium on foot function.


METHODS
The first to third metatarsus defect was simulated in a 3D foot model and rebuilt by ilium. The maximal displacement and stress calculated by the method of finite elements were used as the index of estimation. Five cases treated from Mar. 1996 to Jan. 2003 with metatarsus defect rebuilding by free vascular iliac bone incorporating free flap were evaluated.


RESULTS
Foot function was affected largely by the defect of the first to third metatarsus. Compared with the normal foot, the maximal displacement was increased by 2.15 times and the maximal stress was increased by 2.12 times in 100%-defected foot, and in 50%-defected foot maximal displacement and stress were increased by 1.65 times and 2.05 times respectively. Follow-up had been conducted for 1 to 2 years. All bones and flaps of the 5 cases survived (2 excellent, 2 good, and 1 passable) by function evaluation.


CONCLUSIONS
The first to third metatarsus defect should be repaired, and the method of transplanting iliac bone added by flap is effective.
Pan
Zhaohui
Z
Orthopaedic Institute of PLA, 89th Hospital, Weifang Shandong, PR China.
Wang
Jianli
J
Jiang
Pingping
P
D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D016025:Bone Transplantation; D020342:Finite Element Analysis; D005528:Foot / Q000503:physiopathology; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008297:Male; D008348:Manikins; D008684:Metatarsus / Q000293:injuries* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply