METHODS: Navicular compression, medial extrusion, metatarsal lengths, Kite\'s, lateral and dorsoplantar talo-first metatarsal angles were measured in 95 feet with MWD. Joints involved, presence and location of navicular fracture were recorded.
RESULTS: Group 1 \"early-onset\" MWD feet (n = 11) had greatest compression and medial extrusion, and lowest Kite\'s angles. All except 1 were index minus and had lateral navicular fracture. Only 1 had moderate degeneration at the talonavicular joint (TNJ) with none requiring surgery yet. Group 2 \"Müller-Weissoid\" feet (n = 23) had radiologically normal navicular in their fifties and developed MWD on average 5 years later. They had the lowest compression and extrusion, and highest Kite\'s angles. None had complete fracture. All had TNJ arthritis, with early changes at lateral naviculocuneiform joint (NCJ) in 43%. Group 3 \"late-onset\" MWD presented in the sixth decade. Only TNJ was involved in Group 3 A (n = 16). Group 3B (n = 20) affected TNJ more than NCJ and had the greatest number of Maceira stage V disease. Group 3 C \"reverse Müller-Weiss disease\", which affected NCJ more than TNJ (n = 25), had greatest midfoot abduction and overlength of the second metatarsal. No fracture occurred in group 3 A compared to 65% and 32% in groups 3B and 3 C, respectively.
CONCLUSIONS: With need to compare like-for-like pathology, the proposed classification provides a common platform for reporting outcomes of different treatments. We theorize pathogenetic pathways in the various groups.
方法:舟骨压缩,内侧挤压,跖骨长度,风筝,用MWD在95英尺中测量了外侧和足前角。涉及的关节,记录舟骨骨折的存在和位置。
结果:第1组“早发性”MWD脚(n=11)的压缩和内侧挤压最大,和最低的风筝角度。除1外,其余均为指数减,并有舟骨外侧骨折。只有1人在距骨关节(TNJ)处出现中度变性,尚未需要手术。第2组“Müller-Weissoid”脚(n=23)在50多岁时放射学上正常,平均5年后发展了MWD。他们的压缩和挤压最低,和最高的风筝角度。没有人完全骨折。都有TNJ关节炎,在43%的外侧缝孔型关节(NCJ)出现早期变化。第三组“迟发性”MWD出现在第六个十年。只有TNJ参与组3A(n=16)。3B组(n=20)对TNJ的影响大于NCJ,并且具有最大数量的MaceiraV期疾病。第3组C\“逆转Müller-Weiss病\”,对NCJ的影响大于对TNJ的影响(n=25),中足外展最大,第二跖骨过长。与3B和3C组的65%和32%相比,3A组没有发生骨折。分别。
结论:需要比较同类病理学,拟议的分类为报告不同治疗的结果提供了一个通用平台.我们对各组的致病途径进行了理论化。