■患有中度至重度外翻(HV)的患者有时会出现第二meta趾(MTP)关节脱位。由于足底板(PP)损伤引起的第二MTP关节不稳定已被认为是原因之一。然而,没有定量评估这种不稳定性的报告。本研究旨在通过超声检查评估无脱位HV患者的第二MTP关节不稳定,并探讨其与PP损伤或足部形式的关系。
■在2018年5月至2023年7月之间,有症状的HV女性患者没有任何较小的脚趾畸形被纳入本研究。第二MTP关节不稳定定义为meta骨头关节表面上被动下脱位的近端指骨关节表面的背侧位移比(DDR)。使用超声检查评估PP损伤的存在。脚“形式”是通过在负重脚-脚踝X射线照片上测量标准脚骨角来确定的。研究了DDR或PP损伤与射线照相测量之间的关系。
■纳入64名患者(100英尺)。无脱位的HV患者第二MTP关节的平均DDR为35.7%。PP损伤的概率增加了,高于35.4%的截止DDR值r(曲线下面积=0.712)。敏感性,特异性,正预测值,基于此截止水平,PP损伤存在的阴性预测值为63.9%,74.4%,79.6%,56.9%,分别。在21英尺(21.0%)报告了meta骨痛,其中15英尺(71.4%)显示PP损伤。DDR的增加与meta骨内收角度增加和第二meta骨高度降低弱相关。
■在没有第二次MTP脱位的HV女性患者中,我们发现第二次MTP足底板损伤和关节不稳定的超声检查证据是一个相对常见的发现,在局部meta骨痛患者中患病率较高.
■二级,根据连续患者制定诊断标准。
UNASSIGNED: Patients with moderate to severe hallux valgus (HV) sometimes exhibit second metatarsophalangeal (MTP) joint dislocation. Second MTP joint instability due to plantar plate (PP) injury has been suggested as one of the causes. However, there have been no reports that quantitatively evaluate this instability. This study aimed to evaluate second MTP joint instability in patients with HV without dislocation via ultrasonography and investigate its relationship with the presence of PP injury or foot form.
UNASSIGNED: Between May 2018 and July 2023, symptomatic female patients with HV without any lesser toe deformity were included in this study. Second MTP joint instability was defined as the dorsal displacement ratio (DDR) of the passively subluxated proximal phalangeal articular surface on the metatarsal head articular surface. The presence of PP injury was assessed using ultrasonography. Foot \"form\" was determined by measuring standard foot bony angles on weight-bearing foot-ankle radiographs. The relationship between DDR or PP injury and radiographic measurements was investigated.
UNASSIGNED: Sixty-four patients (100 feet) were included. The average DDR of the second MTP joint in patients with HV without dislocation was 35.7%. There was an increase in the probability of PP injury, above a cutoff DDR value r of 35.4% (area under the curve = 0.712). The sensitivity, specificity, positive predictive value, and negative predictive value for the presence of PP injury based on this cutoff level were 63.9%, 74.4%, 79.6%, and 56.9%, respectively. Metatarsalgia was reported in 21 feet (21.0%), of which 15 feet (71.4%) showed PP injury. An increase in DDR was weakly associated with increased metatarsus adductus angle and decreased second metatarsal height.
UNASSIGNED: In female patients with HV without second MTP dislocation, we found ultrasonographic evidence of second MTP plantar plate injury and joint instability to be a relatively common finding with a high prevalence in those with localized metatarsalgia.
UNASSIGNED: Level II, development of diagnostic criteria based on consecutive patients.