摘要
目的:通过负重CT影像学测量,探究[足母]外翻患者的第二跖骨下疼痛的原因。方法:回顾性选取2020年9月至2021年12月[足母]外翻合并第二跖骨下痛性胼胝患者15例(16足)为外翻跖痛组,以及[足母]外翻不合并第二跖骨下痛性胼胝患者12例(23足)为外翻无痛组,选取同期距骨软骨损伤无足部畸形患者12例(19足)作为对照的距软骨损伤组。测量水平位各个跖骨头最远端至第二跖趾关节面的距离(D-1、D-3、D-4、D-5)。矢状位上测量第二跖骨的绝对长度(L-2),第一、第二、第三跖骨干的倾斜角度(IL-1、IL-2、IL-3)及跖骨头距地距离(H-1、H-2、H-3)。冠状位上测量第一跖骨旋转(α角)及籽骨旋转角度(SAP)。对比三组间测量参数的统计学差异。结果:[足母]外翻跖痛组患者第一、二、三跖骨最低点距地距离明显降低。第一、二、三跖骨倾斜角度三组间差异无统计学意义(P>0.05)。第一跖骨旋前角及籽骨旋转角三组间差异有统计学意义(P<0.05)。SAP:外翻跖痛组(27.60±11.84)°,外翻无痛组(22.74±10.96)°,距软骨损伤组(9.63±6.18)°;α角:外翻跖痛组(10.20±4.96)°,外翻无痛组(12.50±6.18)°,距软骨损伤组(5.92±4.41)°。结论:[足母]外翻合并第二跖骨痛患者存在明显的第一跖骨及籽骨旋前畸形,[足母]外翻角明显增大。术者应注意此类患者的第一跖骨及籽骨旋转畸形,予以纠正。
Objective:To investigate the causes of sub-metatarsal pain in hallux valgus(HV)patients by weight-bearing CT imaging measurements.Methods:Fifty-eight feet(34 participants)assessed between September 2020 and December 2021 were divided into metatarsus pain group(16 feet)as HV patients with second metatarsal keratoses,HV group(23 feet)as HV patients without any calluses,and control group(19 feet)as patients with osteochondral lesions of the talus(OLT).Several parameters were measured in all participants:the distances from the proximal point of each head to the second metatarsophalangeal joint line(D-1,D-3,D-4,and D-5),the second metatarsal shift length(L-2),the heights of the first,second,and third metatarsals to the ground(H-1,H-2,and H-3),,the inclination angle of first,second,and third metatarsals(IL-1,IL-2 and IL-3).Results:HV patients with painful calluses were observed with significant lower distance to ground(H-1,H-2,H-3).No significant difference was found for the IL-1,IL-2 and IL-3.Theαangle and SAP showed significant difference among groups:αangle:metatarsus pain group(27.60±11.84)°,HV group(22.74±10.96)°,control group(9.63±6.18)°;SAP:metatarsus pain group(10.20±4.96)°,HV group(12.50±6.18)°,control group(5.92±4.41)°.Conclusions:HV patients with painful calluses under second metatarsal are found with more pronated first metatarsal and sesamoids.These patients showed increased HV angles.Surgeons should be aware of the metatarsal and sesamoids pronation for these patients and correct the deformities.
作者
李恒
孙宁
武勇
LI Heng;SUN Ning;WU Yong(Department of Foot and Ankle,Beijing Jishuitan Hospital,Beijing 100035,China)
出处
《中华骨与关节外科杂志》
2022年第12期964-970,共7页
Chinese Journal of Bone and Joint Surgery
关键词
[足母]外翻
痛性胼胝
跖骨痛
负重CT
Hallux Valgus
Painful Calluses
Metatarsalgia
Weight Bearing CT
