未经授权:我们经常将外侧踝关节撞击归因于跟骨外翻,而忽略胫骨远端内翻.诊断标准,胫骨远端内翻综合征(DTVS)的严重程度和治疗尚未见报道.这项回顾性研究旨在根据患者的临床症状和影像学表现提出DTVS的诊断和分类系统。
UNASSIGNED:在2010年至2018年期间,共有76例有症状的胫骨远端内翻和踝关节全等患者根据其SF-36评分进行临床评估,AOFAS脚踝后足评分,和VAS评分。每个病人的病史,症状,和MRI图像进行回顾性分析,并观察其负重踝关节X线照片,测量胫骨前表面角(TAS)和胫骨倾斜角(TTA)。使用配对t检验和Kruskal-Wallis检验来比较上述结果。
未经评估:43名男性和33名女性,平均年龄为46岁(范围,28-68岁)包括在内。除了同样的间歇性腓骨下疼痛症状,定义了3种类型的DTVS:(I)I型:胫骨远端倾斜表面,X射线上的胫骨关节一致;(II)II型:胫骨远端倾斜表面,X射线上的胫骨关节一致,MRI图像上外踝下方的软组织水肿;(III)III型:与II型症状相同,MRI图像上的距骨软骨损伤。根据我们提出的分类系统,26例患者被归类为I型,需要保守治疗,22为II型,28为III型,在踝上外翻截骨术中。踝关节功能评价评分,如SF-36(术前74.14±12.50,术后85.22±8.83),AOFAS(术前71.14±15.19,术后87.53±8.62),所有类型的VAS(术前为5.41±1.10,术后为1.82±1.08)评分均显着改善(P<0.01)。所有患者的TAS(术前为80.38°±4.80°,术后为90.44°±3.96°)和TTA(术前为13.02°±3.41°,术后为0.62°±2.67°)均明显改善(P<0.01)。
未经评估:DTVS,导致外侧踝关节撞击,可根据临床表现和影像学表现进行诊断。我们的分类系统可以帮助与适当形式的保守或手术治疗有关的决策过程。
UNASSIGNED: We often attribute the lateral ankle impingement to the valgus calcaneus, while ignoring the varus distal tibia. The diagnostic criteria, severity and treatment of distal tibia varus syndrome (DTVS) have not been reported. This retrospective study sought to propose a diagnosis and classification system for DTVS based on patients\' clinical symptoms and imaging findings.
UNASSIGNED: A total of 76 symptomatic patients with varus distal tibia and congruent ankle examined between 2010 and 2018 were involved to evaluate clinically based on their SF-36 scores, AOFAS ankle-hindfoot scores, and VAS scores. Each patient\'s history, symptoms, and MRI images were analyzed retrospectively, and their weight-bearing ankle radiographs were observed to measure the tibial anterior surface angle (TAS) and tibial tilt angle (TTA). Paired t-test and Kruskal-Wallis test were used to compare the results above.
UNASSIGNED: Forty-three men and 33 women with an average age of 46 years (range, 28-68 years) included. Besides the same symptom of intermittent subfibular pain, 3 types of DTVS were defined: (I) Type I: a sloped surface of the distal tibia with the congruent tibiotalar joint on radiographs; (II) Type II: a sloped surface of the distal tibia with the congruent tibiotalar joint on radiographs, and soft-tissue edema inferior to the lateral malleolus on MRI images; and (III) Type III: the same symptoms as Type II, plus osteochondral lesions of the talus on MRI images. Under our proposed classification system, 26 patients were classified as Type I, requiring conservative treatment, 22 as Type II, and 28 as Type III under supramalleolar valgus osteotomy. The ankle functional evaluation scores, such as the SF-36 (74.14±12.50 preoperatively and 85.22±8.83 postoperatively), AOFAS (71.14±15.19 preoperatively and 87.53±8.62 postoperatively), and VAS (5.41±1.10 preoperatively and 1.82±1.08 postoperatively) scores for all types were significantly improved (P<0.01). The TAS (80.38°±4.80° preoperatively and 90.44°±3.96° postoperatively) and TTA (13.02°±3.41° preoperatively and 0.62°±2.67° postoperatively) of all the patients on the weight-bearing ankle radiographs were significantly improved (P<0.01).
UNASSIGNED: DTVS, causing lateral ankle impingement, can be diagnosed based on clinical manifestations and imaging findings. Our classification system can aid in the decision-making process in relation to the appropriate form of conservative or surgical treatments.