拇趾外翻足的鞋內矯正器之設計與評估; Design and Evaluation of Orthosis within Shoe for Foot with Hallux Valgus

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题名:	拇趾外翻足的鞋內矯正器之設計與評估;Design and Evaluation of Orthosis within Shoe for Foot with Hallux Valgus
作者:	黃敏甄;Min-zhen Huang
贡献者:	機械工程研究所
关键词:	拇趾外翻;矯具;臨床驗證;有限元素分析;finite element of foot;experiments of bunion;Orthosis;Hallux valgus
日期:	2009-07-05
上传时间:	2009-09-21 12:06:29 (UTC+8)
出版者:	國立中央大學圖書館
摘要:	拇指外翻是一種常見於女性的足部疾病。由於女性本身的關節較柔軟，若穿著不符生物力學的鞋款，第一蹠趾關節容易受到壓迫而變形。不但影響了足部的外觀，更在行走時容易疼痛與影響平衡。但有此困擾者不易取得有效且方便的矯正器具，延誤治療下，往往錯過適當的矯正時機。因此建構容易使用且有效的矯具，是本研究的重點。透過了解現行的矯正方法與市面上流通的矯正器具，設計能支撐足弓、並同時矯正趾骨與蹠骨的新型鞋內矯正器。並邀請志願者參與鞋內矯正器的臨床測試。透過拍攝足部外觀追蹤蹠趾角度變化情況，並由實驗前後的X光片，觀察蹠骨間的角度變化，以建立拇趾外翻的矯正流程。並建足部模型進行有限元素分析，比較不同矯具設計對拇趾外翻足的作用效果。經過幾次的檢討與改良，排除可能造成問題的設計，整合後實際造出予實驗使用。受試者在使用本鞋內矯正器後，在外觀上有可見的變化，多數在四個月內獲得改善。從X光的拍攝結果發現，鞋內矯正器不但改善蹠趾關節角度，也對蹠骨間的角度有減少的作用。有限元素分析部份，則可看出鞋內矯正器能給予蹠骨正確的矯正方向，是一般矯正器無法達成的。且鞋內矯正器在蹠趾關節產生的應力與現行病患所使用的矯正器無異。是一可供使用的設計。未來希望能增加成功例，經統計確立鞋內矯正器的效用，傳播相關資訊，加強隱性的拇趾外翻患者對此疾病之認識，若拇趾外翻在初期能獲得改善，便可大大降低女性的煩惱。 Hallux valgus is one of the most common feminine foot disease, females’ joints are usually more flexible. By wearing pairs of shoes without proper biological mechanics design, the first metatarsal joint would easily be pressured to distortion. Not only affect the foot’s appearance, but also affect the balance. Take a look at the current situation, patients are having so much trouble to find effective and efficient orthosis, which leads to delaying the therapy and missing the proper time for rectifying for most of the time. Therefore, designing a handy and effective orthosis is the key purpose of this research. By gaining more knowledge in orthopaedic and orthosis, it helped build the new type of in-shoe orthosis model with the support to the arch of foot, also with the function to rectify the phalanges and metatarsus. Volunteers were invited to participate in the in-shoe orthosis tests and experiments, photos of the foot appearance were taken by month to keep the track of the angle variation of the phalanges and metatarsus for four months, and compared the difference of the X-ray photos taken before and after the experiment to see the angle variation of the metatarsus. Building the foot model and analyzing with finite element, comparing the effects to Hallux valgus between different designs of orthosis. After times of reviewing and improving, in the mean time also eliminating the trouble-causing design, a finalized and integrated model was built up and put into experiments. With the help of the in-shoe orthosis, the variation of the foot appearance of the volunteers were distinct, most were improved within the four months. From the result of the X-ray photos, the in-shoe orthosis not only improved the angle of the phalanx-metatarsus joint but also decreased the angle of the metatarsus. The result of the finite element analysis shows the in-show orthosis provide a proper direction for rectification, which is impossible for regular orthosis. And the stress on the foot while wearing the in-show ortheosis is the same to the orthosis the patients are using nowadays. With those experiment result, it is proved the design is feasible without doubts. In the future, it’s another goal to increase the sample of successful rectification to prove the function of the in-shoe orthosis with statistics. Delivering the information about hallux valgus to help potential patients know more about it and receive better treatment. It helps a lot to solve woman’s vexation by improving hallux valgus in initial stage.
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