距下关节融合术对足底压力分布的影响  

Effects of subtalar fusion on distribution of plantar pressures

作　　者：杨崇林[1] 徐向阳[1] 郭常军[1] 曹永星 杨云峰 Yang Chonglin;Xu Xiangyang;Guo Changjun;Cao Yongxing;Yang Yunfeng(Department of Orthopedics,Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 201801,China)

机构地区：[1]上海交通大学医学院附属瑞金医院骨科,上海201801

出　　处：《中华创伤骨科杂志》2025年第1期64-69,共6页Chinese Journal of Orthopaedic Trauma

基　　金：上海市科委项目(22S31900300);国家科技部重点研发计划课题(2022YFC2009505)。

摘　　要：目的明确单纯距下关节融合术对足底压力分布的影响。方法回顾性分析2006年1月至2020年12月上海交通大学医学院附属瑞金医院骨科单纯接受了距下关节融合术的19例患者资料。男13例,女6例;年龄(42.1±11.8)岁;病程为1.7(1.0,2.0)年。征集14例正常受试者作为对照,男7例,女7例;年龄(25.0±1.9)岁。通过比利时Footscan®足底压力测试仪检测并分析足底压力分布数据。将患者的患侧和健侧分别与正常足比较,分析不同足部分区的峰值压强。结果患者与正常受试者身高、体重比较差异均无统计学意义(P>0.05)。患者患侧前足第1~3跖骨区及后足内侧区的峰值压强显著低于正常足,差异有统计学意义(P<0.05)。正常足前足区的峰值压强出现在第3跖骨区,患者健侧前足区的峰值压强内移出现在第2跖骨区,但患侧的峰值压强向外侧转移,出现第4跖骨区。患者患侧中足区峰值压强[(4.38±2.17)N/cm^(2)]比健侧[(3.04±1.80)N/cm^(2)]高,差异有统计学意义(P=0.035)。患者健侧后足内侧区和后足外侧区峰值分别为(7.12±1.91)N/cm^(2)和(7.98±2.03)N/cm^(2),差异无统计学意义(P=0.086);患侧后足外侧区的峰值压强(10.77±4.21)N/cm^(2)显著大于后足内侧区的峰值压强(8.71±2.89)N/cm^(2),差异有统计学意义(P=0.009)。患者患侧足底压力的峰值压强均向外侧转移。结论距下关节融合术对足底压力分布有影响,患者患侧足底的压力均向外侧转移,患者健侧的前足压力代偿性向内侧转移。ObjectiveTo clarify the effects of simple subtalar fusion on distribution of plantar pressures.MethodsA retrospective study was conducted to analyze the 19 patients who had undergone simple subtalar fusion between January 2006 and December 2020 at Department of Orthopedics,Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine.There were 13 males and 6 females with an age of(42.1±11.8)years and a duration of disease of 1.7(1.0,2.0)years.Another 14 normal subjects were recruited as normal controls[7 males and 7 females,with an age of(25.0±1.9)years].The data of plantar pressure distribution were detected and analyzed by a Belgian Footscan®plantar pressure tester.The affected and healthy sides of the patients were compared with those of the normal group to analyze the peak pressures on different foot regions.ResultsThere was no significant difference in height or weight between the patients and the normal subjects(P>0.05).The peak pressures on the first to the third metatarsal region of the forefoot and the medial region of the hindfoot of the affected foot were significantly lower than those of the normal foot in the patients(P<0.05).The peak pressure on the forefoot region of a normal foot appeared in the third metatarsal region.In the patients,the peak pressure on the forefoot region of a healthy side shifted inward and appeared in the second metatarsal region,but the peak pressure on the forefoot region of an affected side shifted laterally and appeared in the fourth metatarsal region.The peak pressure on the midfoot of an affected side[(4.38±2.17)N/cm^(2)]was significantly higher than that on a healthy side[(3.04±1.80)N/cm^(2)]in the patients(P=0.035).The peak pressures on the medial and lateral hindfoot regions of a healthy side were(7.12±1.91)N/cm^(2) and(7.98±2.03)N/cm^(2),respectively,showing no significant difference(P=0.086).The peak pressure on the lateral hindfoot region of an affected side[(10.77±4.21)N/cm^(2)]was significantly higher than that on the medial hindfoot reg

关 键 词：距下关节 关节融合术 压力 退变 步态 

分 类 号：R68[医药卫生—骨科学]