拇趾外翻足负重位和非负重位下X线测量指标与跖骨头下疼痛的相关性分析  

Correlative analysis on metatarsalgia and the X ray measurement indexes under weight-bearing and non-weight-bearing of hallux valgus

作　　者：龚浩[1] 桑志成[1] 温建民[1] 孙卫东 胡海威[1] 张永超[1] 左建刚[1] 王海雄[1] 

机构地区：[1]中国中医科学院望京医院,北京100102

出　　处：《中国骨伤》2014年第4期303-307,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:通过拇外翻足负重位和非负重位X线测量指标分析,探讨拇外翻畸形时足弓塌陷程度与跖骨头下疼痛的相关性。方法:对2012年5月至2012年10月120例(240足)拇外翻患者跖骨头下疼痛观察并摄患足负重位和非负重位下X线正侧位片,分别测量拇外翻角(HVA)、1-2跖间角(IM1-2)、1-5跖间角(IM1-5)、内弓顶角和前弓角,比较其负重与非负重位下的差异,并分析其(除HVA)差值与拇外翻畸形、跖骨头下疼痛的相关性。结果:120例拇外翻患者240足中148足存在跖骨头下疼痛,拇外翻足负重位IM1-2、IM1-5、内弓顶角较非负重位均明显增加,而拇外翻角和前弓角则反之;负重与非负重位下IM1-2、IM1-5、内弓顶角的差值与拇外翻畸形程度及跖骨头下疼痛密切相关。结论:拇外翻足弓塌陷程度随拇外翻畸形的增加而加重,跖骨头下疼痛随着足弓塌陷程度加重而加重。通过足负重、非负重位下X线测量指标分析可评价拇外翻足弓塌陷程度,对防治跖骨头下疼痛有重要意义。To study changes in the radiographic appearance during weight-bearing and non-weigh-bearing in hallux valgus, and to analyse the correlation between the elasticity of plantar soft tissue of ballux valgus and the pain under the metatarsal head. Methods：From May 2012 to October 2012,240 feet of 120 patients with hallux valgus were enrolled in the study. The degrees of the plan under the metatarsal head of all the patients were observed. AP and lateral X-ray films of feet were taken on the condition of weight-bearing and non-weight-bearing. So the hallux valgus angle （HVA）, the inter-metatarsal angle between the first and second metatarsals （IM1-2）, the inter-metatarsal angle between the first and fifth metatarsals （IM 1- 5 ）, top angle of the medial longitudinal arch （TAOTMLA）, and anterior angle of the medial longitudinal arch （AAOTMLA） were measured on the X-ray films. The differences of HVA,IM1-2,IM1-5 ,TAOTMLA and AAOTMLA between two groups were compared, and the correlation between the changes of IM 1-2, IM1-5, TAOTMLA, AAOTMLA and the degree of the pain under the metatarsal head were analysed. Results：One hundred and forty-eight feet had the pain under the metatarsal head. The IM 1-2, IM1-5 and TAOTMLA increased on weight-bearing position compared with those on non-weight-bearing position, but the HVA and AAOTMLA decreased on weight-bearing position compared with those on non-weight-bearing position. There was a moderate relationship between the changes of IM1-2, IM1-5 and the degree of the hallux valgus deformity, as well as the relationship between the different of IM 1-Sand the degree of the pian under the metatarsal head. Conclusion：The degree of the collapse of the arch of foot with hallux valgus becomes serious with its deformity increasing. The pain under the metatarsal head of hallux valgus increases with the increased changes of IM1-2, IM1-5 and TAOTMLA. Analysis of the X-ray observation indexes of hallux valgus on weight-bearing position and non-weight-bearing position has

关 键 词：放射摄影术 拇外翻 足畸形 跖痛症 

分 类 号：R682.16[医药卫生—骨科学]