Mobility of the first metatarsal-cuneiform joint in patients with and without hallux valgus: in vivo three-dimensional analysis using computerized tomography scan.
Mobility of the first metatarsal-cuneiform joint in patients with and without hallux valgus: in vivo three-dimensional analysis using computerized tomography scan.
复制标题
有或无拇外翻患者第一跖骨-楔形关节的活动度：使用计算机断层扫描进行体内三维分析
DOI：
10.1186/s13018-015-0289-2
复制
发表时间：
2015-09-15
影响因子：
2.6
通讯作者：
Yang J
中科院分区：
文献类型：
--
作者：
Geng X;Wang C;Ma X;Wang X;Huang J;Zhang C;Xu J;Yang J
拇外翻（HV）畸形与第一跖-楔状关节的过度活动密切相关，但对正常足或HV足的该关节的三维活动能力缺乏充分的了解。本研究旨在探讨正常和HV患者在负重状态下第一跖-楔状关节在多个平面上的活动度。方法共10名女性志愿者（20英尺）和10名女性hiv患者（20英尺）参与本研究。使用定制的足部加载设备，在卸载和负重条件下对每双足进行计算机断层扫描（CT）。重建第一跖骨和内侧楔形骨的三维模型。通过逆向工程软件定量评估第一跖骨-楔状关节在多个平面上从卸载到加载状态的旋转和平移运动。结果负重状态下，HV足组第一跖-楔状关节背屈度平均为2.91°（标准差，SD 1.71），对照组为1.18°（SD 0.47） （t= 4.158，P= 0.001）；旋后2.17°（SD 2.28），对照组0.98°（SD 0.81） （t= 2.080，P= 0.045）；内部旋转2.65°（SD 2.22），对照组为0.96°（SD 0.57） （t= 3.114，P= 0.006）。与对照组相比，HV足组关节明显变宽（t= 2.256，P= 0.030），且更倾向于向足背方向移位（t= 1.928，P= 0.063）；两组间中外侧方向的平移量无显著差异。结论在负重过程中，第一跖-楔状关节背屈、旋后、内旋。对于HV足，可以在多个平面上观察到第一跖-楔状关节的过度活动。本研究促进了对第一跖-楔状关节生理和病理活动的进一步了解。
BackgroundHallux valgus (HV) deformity is closely correlated to the hypermobility of the first metatarsal-cuneiform joint, but adequate understanding of the three-dimentional (3D) mobility of this joint in normal or HV feet is lacking. This study was conducted to investigate the mobility of the first metatarsal-cuneiform joint in multiple planes during body weight-bearing conditions for both normal and HV patients.MethodsA total of 10 female volunteers (20 feet) and 10 female HV patients (20 feet) participated in this study. Using a custom-made foot-loading device, computerized tomography (CT) scans of each pair of feet were taken under both unloaded and body weight-bearing conditions. 3D models were reconstructed for the first metatarsal and the medial cuneiform. Rotational and translational motions of the first metatarsal-cuneiform joint in multiple planes from unloaded to loaded conditions were quantitatively evaluated by reverse-engineering software.ResultsDuring body weight-bearing conditions, the first metatarsal-cuneiform joint in HV feet dorsiflexed at an average of 2.91° (standard deviation, SD 1.71) versus 1.18° (SD 0.47) in controls (t= 4.158,P= 0.001); supinated 2.17° (SD 2.28) versus 0.98° (SD 0.81) in controls (t= 2.080,P= 0.045); and internally rotated 2.65° (SD 2.22) versus 0.96° (SD 0.57) in controls (t= 3.114,P= 0.006). Moreover, the joint in HV feet widened significantly compared with the controls (t= 2.256,P= 0.030) and tended to translate more in the dorsal-plantar direction (t= 1.928,P= 0.063); the translation in the medial-lateral direction was not significantly different between the two groups.ConclusionsDuring weight-loading process, the first metatarsal-cuneiform joint turns dorsiflexed, supinated, and internally rotated. For HV feet, hypermobility of the first metatarsal-cuneiform joint can be observed in multiple planes. This study promotes further understanding of the physiological and pathological mobility of the first metatarsal-cuneiform joint.