足弓指数与足部运动学参数的相关性分析及两者在下肢应力性骨折中的特点  

Correlation analysis between arch index and foot kinematic parameters and their characteristics in stress fracture of lower extremity

作　　者：冯勇 赵燕旭 董宏彬 周皓 宗龙泽[2] 万一群 彭江 唐佩福 张民泽[2] 汪爱媛 Feng Yong;Zhao Yanxu;Dong Hongbin;Zhou Hao;Zong Longze;Wan Yiqun;Peng Jiang;Tang Peifu;Zhang Minze;Wang Aiyuan(Senior Department of Orthopedics,Fourth Medical Center of PLA General Hospital,Beijing 100853,China;Department of Orthopedics,Affiliated Hospital of Yan′an University,Yan′an 716000,China;Center for Disease Control and Prevention,Central Theater Command of PLA,Beijing 100042,China;Department of Hand&Foot Trauma Surgery,Shandong Provincial Third Hospital,Jinan 250000,China)

机构地区：[1]中国人民解放军总医院第四医学中心骨科医学部,北京100853 [2]延安大学附属医院骨科,延安716000 [3]山东省立第三医院创伤与手足外科,济南250000 [4]解放军中部战区疾病预防控制中心,北京100042

出　　处：《中华创伤杂志》2022年第9期828-833,共6页Chinese Journal of Trauma

基　　金：军队“十三五”医学专项(16CXZ044);全军后勤科研计划(BWS17B053);国家骨科与运动康复临床研究中心创新基金培育项目(2021-NCRC-CXJJ-PY-22)。

摘　　要：目的分析足弓指数与足部运动学参数之间的关系,并探讨两者在下肢应力性骨折中的特点。方法采用病例对照研究方法,选取陆军某部2019年入伍新兵108人为研究对象。在训练之前,通过电容式足底压力测量系统采集新兵足印图像,以计算足弓指数。通过动态步态体态分析系统采集足部运动学参数。采用Spearman秩相关分析足弓指数与足部运动学参数(着地仰角、离地仰角、拍地速度、着地内翻角、外翻幅度、着地外翻速度)的相关性。由骨科医师对新兵训练进行全程随访,剔除其他类型下肢损伤者(10人),最后对比分析发生下肢应力性骨折的骨折组(19例)和无任何下肢损伤的对照组(79例)的足弓指数及足部运动学参数。结果(1)新兵足弓指数为0.21(0.12,0.25),着地仰角为(17.31±4.02)°,离地仰角为(63.90±5.63)°,拍地速度为(176.85±24.39)°/s,着地内翻角为(13.64±4.44)°,外翻幅度为(12.16±3.42)°,着地外翻速度为382.50(311.05,474.80)°/s。(2)着地内翻角(r=0.25,P<0.01)及外翻幅度(r=0.14,P<0.05)与足弓指数正相关。(3)骨折组的足弓指数为0.20(0.07,0.24),离地仰角为(61.59±5.51)°,着地外翻速度为336.00(251.02,428.67)°/s,显著小于对照组的0.23(0.17,0.26)、(64.79±4.79)°、381.20(313.63,470.92)°/s(P<0.05或0.01)。两组着地仰角、拍地速度、着地内翻角、外翻幅度差异无统计学意义(P均>0.05)。结论足弓指数的变化会影响足的着地内翻角及外翻幅度;发生下肢应力性骨折的新兵具有足弓较高、离地仰角较小、着地外翻速度较小的特点。Objective To analyze the relationship between arch index and foot kinematic parameters and their characteristics in stress fracture of lower extremity.Methods A case-control study was performed for 108 recruits selected from a certain army unit in 2019.Before training,the recruits′foot print images were collected by the capacitive plantar pressure measurement system to calculate their arch indices.The kinematic characteristics of the foot were analyzed by the dynamic gait posture analysis system.Spearman rank correlation analysis between arch index and foot kinematic parameters including landing elevation angle,toe-off angle,landing speed,landing varus angle,valgus amplitude and landing valgus speed were performed.Throughout the training,orthopedic physicians followed up the recruits,among whom 10 were excluded due to other types of lower extremity injuries.The arch index and foot kinematic characteristics were analyzed and compared between the remained recruits with stress fracture of lower extremity(fracture group,n=10)and those without lower extremity injury(control group,n=79).Results(1)For the recruits,the arch index was 0.21(0.12,0.25),with landing elevation angle for(17.31±4.02)°,toe-off angle for(63.90±5.63)°,landing speed for(176.85±24.39)°/s,landing varus angle for(13.64±4.44)°,valgus amplitude for(12.16±3.42)°,and landing valgus speed for 382.50(311.05,474.80)°/s.(2)The landing varus angle(r=0.25,P<0.01)and valgus amplitude(r=0.14,P<0.05)were positively related to the arch index.(3)The arch index,toe-off angle and landing valgus speed were 0.20(0.07,0.24),(61.59±5.51)°and 336.00(251.02,428.67)°/s in fracture group,significantly lower than 0.23(0.17,0.26),(64.79±4.79)°and 381.20(313.63,470.92)°/s in control group(P<0.05 or 0.01).There were no significant differences in the landing elevation angle,landing speed,landing varus angle and valgus amplitude between the two groups(all P>0.05).Conclusions The change of the arch index can affect the landing varus angle and valgus amplitude of t

关 键 词：骨折 应力性 生物力学现象 足弓 

分 类 号：R683.42[医药卫生—骨科学]