背景:研究表明,第一跖骨有助于外翻。近端指骨,另一个定义外翻角度的因素,也有助于外翻的发展。没有关于使用计算机断层扫描来评估近端指骨的骨形态的报道。目的利用计算机断层扫描技术分析近端指骨的形态和畸形及其与外翻的关系,并考虑拇指外翻近端指骨手术的适应症。
方法:在2019年5月至2022年3月期间在我们的诊所咨询足部和踝关节疾病并接受负重X线摄影和计算机断层扫描的患者被纳入研究。外翻角,种骨半脱位,第一跖骨长度,近端指骨长度,meta骨-近端指骨比,近端指骨外翻角,跖骨-近端指骨角度,近端指骨旋转角度,测量远端指骨-近端指骨角度。在外翻组和对照组之间比较这些参数。在外翻组,使用负重射线照片测量和比较拇指外翻和近端指骨外翻角。
结果:本研究包括65例患者中的83英尺被诊断为外翻(外翻组;平均年龄为68.0±13.8岁),22例无外翻患者中的30英尺(对照组;平均年龄为67.0±25.8岁)。近端指骨长度,meta骨-近端指骨比率和角度,外翻组远端指骨-近端指骨角度明显大于对照组。然而,两组间指骨近端外翻和旋转角度无显著差异。
结论:由于近端指骨形态没有显着差异,除了长度,在外翻和对照组之间,近端指骨截骨的适应症应仔细考虑。
BACKGROUND: Studies have shown that the first metatarsal contributes to hallux valgus. The proximal phalanx, another factor that defines the hallux valgus angle, also contributes to the development of hallux valgus. There have been no reports on the use of computed tomography to evaluate bone morphology of the proximal phalanx. The purpose of this study was to analyze the morphology and deformity of the proximal phalanx and its relationship to hallux valgus using computed tomography, and to consider the indications for proximal phalanx surgery in hallux valgus.
METHODS: Patients who consulted at our clinic for foot and ankle disorders and underwent both weight-bearing radiography and computed tomography between May 2019 and March 2022 were included in the study. The hallux valgus angle, sesamoid subluxation, first metatarsal length, proximal phalanx length, metatarsal-proximal phalanx ratio, proximal phalanx valgus angle, metatarsal-proximal phalanx angle, proximal phalanx rotation angle, and distal phalanx-proximal phalanx angle were measured. These parameters were compared between the hallux valgus and control groups. In the hallux valgus group, the hallux valgus and proximal phalanx valgus angles were measured and compared using weight-bearing radiographs.
RESULTS: A total of 83 feet in 65 patients were diagnosed with hallux valgus (hallux valgus group; mean age of 68.0 ± 13.8 years) and 30 feet in 22 patients without hallux valgus (control group; mean age of 67.0 ± 25.8 years) were included in the study. The proximal phalanx length, metatarsal-proximal phalanx ratio and angle, and distal phalanx-proximal phalanx angle were significantly greater in the hallux valgus group than in the control group. However, the proximal phalanx valgus and rotation angles were not significantly different between the groups.
CONCLUSIONS: Since there was no significant difference in the proximal phalanx morphology, except length, between the hallux valgus and control groups, the indications for osteotomy of the proximal phalanx should be carefully considered.