PDF(Pubmed)
Abstract：
OBJECTIVE: To assess whether a correlation between the calcaneal pronation angle and the presence of internal plantar arch overload signs (such as upper-medial spring ligament lesion, posterior tibial tendon tenosynovitis, etc.) could lead to a better understanding of coxa pedis pathology.
METHODS: One hundred ankle MRIs of consecutive patients were retrospectively reviewed measuring the calcaneal pronation angle and either the presence or absence of internal plantar arch overload signs. Next, the association of overload signs with increasing pronation angle was evaluated to establish a cut-off point beyond which coxa pedis pathology could be defined.
RESULTS: The tibial-calcaneal angle values in patients with and without effusion proved to be significantly different (p < 0.0001). The tibial-calcaneal angle values in patients with and without oedema also demonstrated a significant difference (p < 0.0056). Regarding posterior tibial tendon, a significant difference was found between the two groups (p < 0.0001). For plantar fascia enthesopathy, the result was borderline significant (p < 0.054). A linear correlation was found between the value of pronation angle and the extent of spring ligament injury (p < 0.0001). In contrast, no correlation with age was found.
CONCLUSIONS: In conclusion, the literature associates medial longitudinal plantar arch overload with posterior tibial tendinopathy and spring ligament complex injuries. Our data show that both injuries are highly correlated with increased calcaneal pronation angle, which could be considered a predictive sign of internal plantar arch overload, prior to the development of the associated signs.
METHODS: One hundred ankle MRIs of consecutive patients were retrospectively reviewed measuring the calcaneal pronation angle and either the presence or absence of internal plantar arch overload signs. Next, the association of overload signs with increasing pronation angle was evaluated to establish a cut-off point beyond which coxa pedis pathology could be defined.
RESULTS: The tibial-calcaneal angle values in patients with and without effusion proved to be significantly different (p < 0.0001). The tibial-calcaneal angle values in patients with and without oedema also demonstrated a significant difference (p < 0.0056). Regarding posterior tibial tendon, a significant difference was found between the two groups (p < 0.0001). For plantar fascia enthesopathy, the result was borderline significant (p < 0.054). A linear correlation was found between the value of pronation angle and the extent of spring ligament injury (p < 0.0001). In contrast, no correlation with age was found.
CONCLUSIONS: In conclusion, the literature associates medial longitudinal plantar arch overload with posterior tibial tendinopathy and spring ligament complex injuries. Our data show that both injuries are highly correlated with increased calcaneal pronation angle, which could be considered a predictive sign of internal plantar arch overload, prior to the development of the associated signs.
摘要：
目的：评估跟骨旋前角与内足弓过载征象（例如上内侧弹簧韧带病变，胫骨后肌腱腱鞘炎，等。)可能会导致更好地理解双足的病理学。
方法：回顾性分析了连续患者的100例踝关节MRI，测量了跟骨旋前角以及是否存在足底内弓过载体征。接下来,对超负荷征象与旋前角增大的相关性进行了评估,以建立一个临界点,超过该临界点可以定义足足地病变.
结果：有和没有积液的患者的胫骨-跟骨角度值被证明存在显着差异（p<0.0001）。有和没有水肿的患者的胫骨-跟骨角度值也显示出显着差异（p<0.0056）。关于胫骨后肌腱，两组间有显著差异(p<0.0001).对于足底筋膜病，结果为临界显著性(p<0.054)。内旋角值与弹簧韧带损伤程度呈线性相关(p<0.0001)。相比之下,没有发现与年龄相关。
结论：结论：文献将内侧纵足弓超负荷与胫骨后肌腱病和弹簧韧带复合体损伤联系起来。我们的数据表明，两种损伤都与跟骨旋前角增加高度相关，这可以被认为是足弓内部过载的预测信号，在相关标志发展之前。
方法：回顾性分析了连续患者的100例踝关节MRI，测量了跟骨旋前角以及是否存在足底内弓过载体征。接下来,对超负荷征象与旋前角增大的相关性进行了评估,以建立一个临界点,超过该临界点可以定义足足地病变.
结果：有和没有积液的患者的胫骨-跟骨角度值被证明存在显着差异（p<0.0001）。有和没有水肿的患者的胫骨-跟骨角度值也显示出显着差异（p<0.0056）。关于胫骨后肌腱，两组间有显著差异(p<0.0001).对于足底筋膜病，结果为临界显著性(p<0.054)。内旋角值与弹簧韧带损伤程度呈线性相关(p<0.0001)。相比之下,没有发现与年龄相关。
结论：结论：文献将内侧纵足弓超负荷与胫骨后肌腱病和弹簧韧带复合体损伤联系起来。我们的数据表明，两种损伤都与跟骨旋前角增加高度相关，这可以被认为是足弓内部过载的预测信号，在相关标志发展之前。
