负重正位联合籽骨轴位对踇外翻腓侧籽骨位置的评估  

The position of the fibular sesamoid bone of hallux valgus was assessed by weight-bearing anteroposterior and sesamoid axial radiographs

作　　者：王敏[1] 罗昕[1] 曹金凤 王凤丽 亓开 WANG Min;LUO Xin;CAO Jinfeng;WANG Fengli;QI Kai(Department of Radiology,Zibo Central Hospital,Zibo,Shandong Province 255036,China;Department of Imaging,Zhangdian District People's Hospital of Zibo City,Zibo,Shandong Province 255025,China)

机构地区：[1]淄博市中心医院放射科,山东淄博255036 [2]淄博市张店区人民医院影像科,山东淄博255025

出　　处：《实用放射学杂志》2024年第1期92-95,共4页Journal of Practical Radiology

摘　　要：目的探讨足负重正位片(体现足静止承重状态)及籽骨负重轴位片(体现足运动状态)2种状态下,随踇外翻加重腓侧籽骨位置的变化。方法临床怀疑踇外翻足74例,最终入组49足,其中轻度组14足,中度组23足,重度组12足,于正位及轴位测量3个指标:正位片腓侧籽骨位置(SP)、轴位片腓侧籽骨位置(SAP)、轴位片腓侧籽骨关节面旋转角(RA_(f))。用腓侧籽骨至第2跖骨垂直距离表示腓侧籽骨位置,则腓侧籽骨位置于正位、轴位具体标记为SP_(f-2)、SAP_(f-2)。为矫正各足解剖差异,将所测距离指标与第2跖骨长度(AB)的比值即SP_(f-2)/AB、SAP_(f-2)/AB纳入统计分析。结果SP_(f-2)/AB及SAP_(f-2)/AB均在踇外翻组间无显著性差异(P>0.05);SP_(f-2)/AB与SAP_(f-2)/AB均值差异有统计学意义(P<0.05);RAf与踇外翻角(HVA)呈显著正相关(r=0.725,P<0.001),随HVA增大而增大。结论负重正位片及籽骨轴位片时(即足静止及运动状态下)腓侧籽骨位置均不受踇外翻影响,腓侧籽骨中心至第2跖骨距离不变;正位片与轴位片比较,两者的腓侧籽骨位置并不相同,则临床进行腓侧籽骨位置研究时需在2种状态下分别进行评价、2种方法需相结合;轴位片时RAf随HVA增大而增大,判定足运动状态下腓侧籽骨中心位置虽不变但随踇外翻加重朝向胫侧做逆向自旋运动。Objective To investigate the changes in the position of the fibular sesamoid bone with hallux valgus aggravated under two conditions:the foot bearing anteroposterior radiography(reflecting the static bearing state of the foot)and the sesamoid bone bearing axial radiography(reflecting the foot movement state).Methods Seventy-four feet with clinically suspected hallux valgus were finally enrolled in 49 feet,including 14 in the mild group,23 in the moderate group,and 12 in the severe group.Three indicators were measured on anteroposterior and axial radiographs:the position of the fibular sesamoid bone in anteroposterior radiographs(SP)and sesamoid axial position(SAP),and the rotation angle of the fibular sesamoid articular surface(RA_(f)).The vertical distance between the fibular sesamoid bone and the second metatarsal bone was used to represent the position of the fibular sesamoid bone,then the position of the fibular sesamoid in the anteroposterior and axial positions was specifically marked as SP_(f-2) and SAP_(f-2).To correct the anatomical differences of each foot,the ratio of the measured distance index to the length of the second metatarsal bone(AB),namely SP_(f-2)/AB,SAP_(f-2)/AB,was included in the statistical analysis.Results SP_(f-2)/AB and SAP_(f-2)/AB had no significant difference between hallux valgus groups(P>0.05).The mean values of SP_(f-2)/AB and SAP_(f-2)/AB were significantly different(P<0.05).RA,was positively correlated with hallux valgus angle(HVA)(r=0.725,P<0.001),increased as HVA increased.Conclusion Both weight-bearing anteroposterior and sesamoid axial radiographs(foot at rest and in motion),the position of the fibular sesamoid bone is not affected by hallux valgus,and the distance from the center of the fibular sesamoid bone to the second metatarsal bone remains unchanged.The position of the fibular sesamoid bone is not the same between the anteroposterior and axial radiographs,so it is necessary to evaluate the position of the fibular sesamoid bone in the two states respectively and comb

关 键 词：踇外翻 籽骨 负重 放射摄影术 

分 类 号：R681.7[医药卫生—骨科学] R814.41[医药卫生—外科学]