Predicting articular erosion in hallux valgus: clinical, radiographic, and intraoperative analysis.
Predicting articular erosion in hallux valgus: clinical, radiographic, and intraoperative analysis.
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DOI：
10.1053/j.jfas.2004.11.012
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发表时间：
2005-01-01
期刊：
影响因子：
--
通讯作者：
Landsman, Adam S
中科院分区：
文献类型：
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作者：
Roukis, Thomas S;Weil, Lowell Scott;Landsman, Adam S
作者提出了一个前瞻性的评估，在手术中的第一跖骨，胫骨和腓骨的籽骨关节磨损模式，以及近节指骨底部的166个足拇指外翻手术。收集的数据与各种临床参数和放射学测量进行比较，以确定这些变量中是否有任何一个可以预测关节侵蚀的发生率和位置。随着患者年龄(P=.000)、跖间角1-2(P=.004)、拇外展角(P=.000)、胫骨籽骨位置(P=.016)和近端关节成角(P=.02)的增加，关节侵蚀的发生率和可预测性显著增加。足型(即指长模式)、跖骨前伸距离、跖头形状和拇指间外展肌之间的相关性不显著。因此，术前临床参数(如年龄)和X线片测量(如跖间角1-2、拇外展角、胫骨籽骨位置和近侧关节成角)可以直接确定关节侵蚀的发生率和位置，有助于拇外翻畸形的术前评估。此外，几乎每个评估的第一跖趾关节都有不同程度的关节侵蚀，在某些情况下(例如，高龄和近端关节成角增加)，它是普遍和广泛的。
The authors present a prospective intraoperative evaluation of the articular wear pattern of the first metatarsal, tibial and fibular sesamoids, and base of the proximal phalanx of 166 feet undergoing hallux valgus surgery. The collected data were compared with various clinical parameters and radiographic measurements to determine if any of these variables can predict the incidence and location of articular erosion. The incidence and predictability of the location of the articular erosion increased significantly as the patient's age ( P = .000), intermetatarsal angle 1-2 ( P = .004), hallux abductus angle ( P = .000), tibial sesamoid position ( P = .016), and proximal articular set angle ( P = .02) increased. The association of foot type (ie, digital length pattern), metatarsal protrusion distance, metatarsal head shape, and hallux abductus interphalangeus was not significant. Therefore, preoperative clinical parameters (ie, age) and radiographic measurements (ie, intermetatarsal angle 1-2, hallux abductus angle, tibial sesamoid position, and proximal articular set angle) can directly define the incidence and location of articular erosion and are helpful in the preoperative assessment of the hallux valgus deformity. In addition, nearly every first metatarsophalangeal joint evaluated had some degree of articular erosion and, in certain circumstances (ie, advanced age and increased proximal articular set angle), it was universal and extensive.