摘要
目的观察正常步态周期中跖骨头平面足横弓的运动形态 ,探讨跖骨头平面足横弓在行走过程中的重要意义及与外翻的关系。方法正常足 13足，外翻足 12足，应用" C"型臂 X线机观察跖骨头平面足横弓在步态周期中的运动形态、空间位置变化，并用录像机记录。电脑工作站与 C＋＋ Builder下精确的计时器相连接，记录足横弓塌陷时间。结果跖骨头平面存在由五个跖骨头构成的足横弓 ,以第一、五跖骨头为底，第二、三跖骨头为顶；在步态周期中，由站立相到推离相时，第二、三跖骨头逐渐塌陷，负重份额渐增加；足横弓指数 Q与外翻角 (HVA)相关， HVA越大， Q值越小，步态周期中第二、三跖骨头下降到地面的时间越短，第二、三跖骨头就越早负重，负重时间延长，导致其过度负重和第二、三跖骨头下疼痛性胼胝体形成。结论跖骨头平面足横弓在正常步态周期中发挥重要作用，由站立相至推离相，随重心前移，第二、三跖骨头的负重增加，跖骨头下移而与地面接触导致足横弓的塌陷。外翻患者中，足横弓塌陷时间早，跖骨头负重时间长，可以导致前足功能紊乱。
Objective To study the spatial change of transverse arch in the metatarsal head during a normal walking cycle, demonstrate the significance of transverse arch in normal walking and the relationship with hallux valgus. Methods A modeling gait cycle was obtained under the C- armed machine, the coronal spatial change of the transverse arch of the metatarsal head were recorded using video tape. On computer work station, the images from video tape were transformed to mpeg files. A model of the transverse arch was created for the analysis of the relationship between the transverse arch index Q and sinking time; between Q and I andⅡ intermetatarsal angle;Ⅰ andⅣ intermetatarsal angle; sinking time and body mass. Results There was a transverse arch formed by the 5 metatarsal heads. In normal walking, during standing phase to toe- off phase, the 2 and 3 metatarsal heads approach the ground resulting in sinking of the transverse arch. The transverse arch index had an adverse relationship with the hallux valgus angle. The time of the transverse arch sinking decrease accompanying with the transverse index Q. Conclusion The transverse arch of metatarsals played an important role during normal gait cycle. During normal walking, when the center of pressure moved forward, the force acting on the 2 and 3 metatarsal was increasing. So, the metatarsal heads drop down resulting in sinking of the transverse arch of the metatarsal head. In hallux valgus patients, the time of transverse arch sinking was earlier than normal and duration was longer. The total force acting on the 2 and (or) 3 metatarsal increased, which may caused disorder of forefoot.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2001年第3期134-136,共3页
Chinese Journal of Orthopaedics
