Arinci Incel Nurgül, Genç H, Erdem H R, Yorgancioglu Z R
Department of Physical Medicine and Rehabilitation, Ankara Education and Research Hospital, Ankara, Turkey.
Am J Phys Med Rehabil. 2003 May;82(5):345-9. doi: 10.1097/01.PHM.0000064718.24109.26.
Hallux valgus is a very common foot deformity in modern societies. Muscle imbalance in abductor and adductor muscles was cited as a major factor in the production of hallux valgus. Our aim in this study was to evaluate the role of certain muscles in this deformity.
Twenty hallux valgus patients and 20 healthy volunteers participated in the study. After thorough physical, neurologic, and radiographic investigations, we performed an electromyographic study to observe the relationship of hallux valgus deformity with the muscles coordinating first metatarsophalangeal joint movements. Voluntary extension, flexion, abduction, and adduction at the hallux with maximum resistance were performed. Firing rates and amplitudes of motor unit potentials of four muscles: musculus abductor hallucis, musculus adductor hallucis, musculus extensor hallucis longus, and musculus flexor hallucis brevis were recorded. Statistical analysis, including Spearman's correlation analysis and Mann-Whitney U tests were performed with SPSS 8.0 for Windows.
We observed that in the hallux valgus group, abduction activity of musculus abductor hallucis was markedly decreased when compared with adduction of musculus adductor hallucis. Motor unit potential amplitude of abductor activity recorded from musculus abductor hallucis was slightly more than half of the activity in flexion.
Muscle imbalance in abductor and adductor muscles is apparent in hallux valgus deformity, and this imbalance may be the reason or the result of joint deformity.
拇外翻在现代社会是一种非常常见的足部畸形。拇展肌和拇收肌的肌肉失衡被认为是拇外翻形成的主要因素。本研究的目的是评估某些肌肉在这种畸形中的作用。
20名拇外翻患者和20名健康志愿者参与了本研究。在进行全面的体格、神经学和影像学检查后,我们进行了肌电图研究,以观察拇外翻畸形与协调第一跖趾关节运动的肌肉之间的关系。对拇趾进行最大阻力下的主动伸展、屈曲、外展和内收动作。记录了四块肌肉的运动单位电位的发放频率和波幅,这四块肌肉分别为:拇展肌、拇收肌、拇长伸肌和拇短屈肌。使用SPSS 8.0 for Windows进行统计分析,包括Spearman相关分析和Mann-Whitney U检验。
我们观察到,在拇外翻组中,与拇收肌的内收活动相比,拇展肌的外展活动明显减少。拇展肌记录到的外展活动的运动单位电位波幅略高于屈曲活动的一半。
拇外翻畸形中拇展肌和拇收肌存在明显的肌肉失衡,这种失衡可能是关节畸形的原因或结果。