Load Response of the Tarsal Bones in Patients with Flatfoot Deformity: In vivo 3D Study
Load Response of the Tarsal Bones in Patients with Flatfoot Deformity: In vivo 3D Study
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DOI：
10.3113/fai.2011.1017
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发表时间：
2011-11-01
影响因子：
2.7
通讯作者：
Kubo, Toshikazu
中科院分区：
文献类型：
--
作者：
Kido, Masamitsu;Ikoma, Kazuya;Kubo, Toshikazu
背景：本研究的目的是通过分析负重期间的重建三维 (3D) CT 图像数据来评估后足各关节的骨旋转，并比较健康足与扁平足的负荷反应。方法：对21只健康足和21只扁平足畸形足进行空载状态下CT扫描，然后进行全身负重负载状态下的CT扫描。后足骨骼的图像被重建为 3D 模型。采用三平面体积合并法计算胫距关节中距骨相对于胫骨的位置、距舟关节中舟骨相对于距骨的位置、距跟关节中跟骨相对于距骨的位置。结果：与健康足相比，扁平足的胫距关节中相对于胫骨的距骨位置差异相对于胫骨的跖屈程度增加了 1.7 度 (p = 0.031)。距舟关节中相对于距骨的负载响应的舟骨位置差异多外翻 2.3 度 (p = 0.0034)。距跟关节中相对于距骨的负载响应的跟骨位置差异为背屈多 1.1 度 (p = 0.0060) 和外翻多 1.7 度 (p = 0.0018)。结论：参考以往的尸体研究，平足患者的负重后足部不仅存在尸足，活足也出现关节不稳定。临床相关性：本研究中使用的方法未来可能应用于足部疾病的临床分析（例如平足的分期）以及生物力学分析以评估足部手术的效果。
Background: The objective of this study was to evaluate the bone rotation of each joint in the hindfoot and compare the load response in healthy feet with that in flatfeet by analyzing the reconstructive three-dimensional (3D) CT image data during weightbearing. Methods: CT scans of 21 healthy feet and 21 feet with flatfoot deformity were taken in non-load condition followed by full-body weightbearing load condition. The images of the hindfoot bones were reconstructed into 3D models. The volume merge method in three planes was used to calculate the position of the talus relative to the tibia in the tibiotalar joint, the navicular relative to the talus in talonavicular joint, and the calcaneus relative to the talus in the talocalcaneal joint. Results: The talar position difference to the load response relative to the tibia in the tibiotalar joint in a flatfoot was 1.7 degrees more plantarflexed in comparison to that in a healthy foot (p = 0.031). The navicular position difference to the load response relative to the talus in the talonavicular joint was 2.3 degrees more everted (p = 0.0034). The calcaneal position difference to the load response relative to the talus in the talocalcaneal joint was 1.1 degrees more dorsiflexed (p = 0.0060) and 1.7 degrees more everted (p = 0.0018). Conclusion: Referring to previous cadaver study, regarding not only the cadaveric foot, but also the live foot, joint instability occurred in the hindfoot with load in patients with flatfoot. Clinical Relevance: The method used in this study might be applied to clinical analysis of foot diseases such as the staging of flatfoot and to biomechanical analysis to evaluate the effects of foot surgery in the future.