Association of Cavovarus Foot Alignment With Peroneal Tendon Tears
Association of Cavovarus Foot Alignment With Peroneal Tendon Tears
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DOI：
10.1177/1071100721990348
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发表时间：
2021-06-01
影响因子：
2.7
通讯作者：
Brodsky, James W.
中科院分区：
文献类型：
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作者：
Taniguchi, Akira;Alejandro, Shannon F.;Brodsky, James W.
虽然临床上广泛接受的原则是内翻畸形易导致腓骨肌腱问题，但支持这一假设的数据有限。这项研究验证了内翻与腓骨肌腱撕裂相关的假设，并评估了哪些放射学测量与这种关联相关。方法：对234例手术治疗的慢性症状性腓骨肌腱撕裂患者的内翻X线测量进行了回顾性比较，并与匹配的对照组进行了比较。测量指标包括跟骨螺距、距跟骨前后角、距跟角、距舟覆盖角。一种新的坐标系分析了野猪的中足和后足成分。结果：腓骨短肌撕裂占73%，长肌腱占8%，双肌腱占19%。与对照组相比，研究组和亚组均有多项指标增加，包括跟骨距增大(P=.0001)、距第一跟骨角减小(P=.0001)和距舟覆盖角增大(P=.0001)。在Yokokura描述的坐标系中，发现内侧纵弓抬高，后足的X线片轮廓发生旋转变化。结论：与对照组相比，本研究发现腹内翻畸形增加与腓骨肌腱撕裂有统计学意义的相关性。它记录了在一个大型手术系列中腓骨短肌、腓骨长肌撕裂和伴随撕裂的相对发生率。结果显示，腹内翻畸形的简单X线片角度和复杂的坐标测量与腓骨肌腱撕裂显著相关。
BackgroundAlthough it is a widely accepted clinical principle that cavovarus deformity predisposes to peroneal tendon problems, there are limited data to support that assumption. This study tested the hypothesis that cavovarus is associated with peroneal tendon tears and evaluated which radiographic measures correlated with that association.Methods:A retrospective comparison of radiographic measures of cavovarus in 234 consecutive patients operatively treated for chronically symptomatic peroneal tendon tears was compared to a matched control group. Measures included calcaneal pitch, anteroposterior (AP) talometatarsal and talocalcaneal angles, and talonavicular coverage angle. A novel coordinate system analyzed midfoot and hindfoot components of cavovarus. Analysis of variance was used to compare cohorts, and a Tukey-Kramer test used to analyze 3 subgroups of brevis and longus tears, and concomitant tears.Results:The distribution of tears was 73% peroneus brevis, 8% longus, and 19% both tendons. Compared with controls, the study group, and subgroups, had multiple measures of increased cavovarus, including greater calcaneal pitch (P = .0001), decreased AP talo-first metatarsal angle (P = .0001), and increased talonavicular coverage angle (P = .0001). Elevated medial longitudinal arch, and rotational changes in the radiographic profiles of the hindfoot were found with the coordinate system described by Yokokura.Conclusion:This study found a statistically significant association of increased cavovarus deformity with peroneal tendon tears, compared to controls. It documented the relative incidence of tears of peroneus brevis, peroneus longus, and concomitant tears in a large surgical series. It demonstrated which simple radiographic angles and complex coordinate measurements of cavovarus deformity were significantly associated with peroneal tendon tears.