Pathological kinematic patterns of the tarsal complex in stage II adult-acquired flatfoot deformity
Pathological kinematic patterns of the tarsal complex in stage II adult-acquired flatfoot deformity
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成人获得性平足畸形 II 期跗骨复合体的病理运动学模式
DOI：
10.1002/jor.23821
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发表时间：
2019-02-01
影响因子：
2.8
通讯作者：
Wang, Kan
中科院分区：
文献类型：
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作者：
Wang, Chen;Wang, Heng;Wang, Kan
成人获得性足部畸形(AAFD)患者在步态站立期的在体运动学特征尚不清楚。这项研究包括7名健康受试者(14足)和12名AAFD II期患者(14足)。在CT扫描的基础上，重建颧骨的三维模型。每个受试者在单一的透视系统上采取标准步态。收集连续的侧位透视图像。选择了站姿阶段的关键姿势。应用2D-3D配准技术研究了踝关节在6个自由度(DOF)下的空间运动。在整个站立期，距舟关节在矢状面的活动度为13+/-6度，而正常人的活动度为7+/-3度(p=0.004)。距下关节在冠状面和水平面的活动度分别为19+/-8度和7+/-3度，而正常人分别为14/-4度(p=0.031)和11+/-3度(p=0.014)。另外，AAFD患者的STJ在负重承受阶段的背屈明显减少，在负重承受阶段和单肢支撑时的外旋显著减少。综上所述，对于II期AAFD患者，在步态站姿阶段，距舟关节和距下关节分别表现为背屈/前屈和内翻/外翻的高度活动度，而距下关节的内/外旋转减少。目前的研究提高了我们对AAFD患者颧骨复合体的病理运动学的理解。在临床实践中，应注意AAFD患者的踝关节活动度。(三)2017年骨科研究会。由Wiley期刊公司出版，J Orthop Res 37：477-482,2019年。
The in vivo kinematic characteristics of the tarsal joints during gait stance phase were still unclear in adult-acquired foot deformity (AAFD). This study included seven healthy subjects (14 feet) and 12 stage II AAFD patients (14 feet). The 3D models of tarsal bones were reconstructed based on CT scan. Each subject took standard gait on the single fluoroscopy system. Continuous lateral fluoroscopic images were collected. The key postures during the stance phase were selected. The 2D-3D registration technique was applied to explore the spatial motions of the tarsal joints in 6 degrees of freedom (DOF). During the whole stance phase, the AAFD talo-navicular joint (TNJ) exhibited ROM of 13 +/- 6 degrees in the sagittal plane while the normal subjects showed ROM of 7 +/- 3 degrees (p = 0.004). In AAFD, the subtalar joint (STJ) demonstrated 19 +/- 8 degrees and 7 +/- 3 degrees of motion in coronal and horizontal plane, respectively, while the normal subjects showed 14 +/- 4 degrees(p = 0.031) and 11 +/- 3 degrees (p = 0.014) of motion, respectively. Additionally STJ of AAFD patients showed significantly less dorsiflexion during the weight acceptance and showed significantly less external rotation both during the weight acceptance and single limb support of stance phase. In conclusion, for stage II AAFD patients, the talonavicular joint and the subtalar joint showed hypermobility in dorsi/planterflexion and inversion/eversion, respectively, during the gait stance phase while the internal/external rotation of the subtalar joint was reduced. The current study improves our understanding of the pathological kinematics of the tarsal complex in AAFD patients. Notice should be taken about these tarsal joints mobility in AAFD during clinical practice. (c) 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:477-482, 2019.