Ebel Christine Maria Isabel, Prodinger Peter M, Mühlhofer Heinz, Müller-Gerbl Magdalena, Linsenmaier Ulrich, Putz Reinhard
Anatomische Anstalt der Ludwig-Maximilians Universität, Pettenkoferstr. 11, Munich 80336, Germany.
Surg Radiol Anat. 2010 Feb;32(2):107-13. doi: 10.1007/s00276-009-0554-3.
Undefined middle foot pain among older individuals is an increasingly problem. Thereby the tarso-metatarsal joints (Lisfranc's joint, TMT joints) are particularly important for foot structure. The aim of this study was to obtain into force transmission in TMT joints by analysing degenerative morphological changes (DMC) of the articular cartilage and subchondral density patterns.
We used seven formalin-fixed foot preparations (average age 80.8) from the undergraduate dissection course. Applying the Collins schema, localisation of cartilaginous surface DMC was examined. For showing subchondral density patterns, the well-established method of CT-osteoabsorptiometry (CT-OAM) was used.
The cartilaginous surface DMCs were frequently located at the medial edges. Maximum density areas were found at the medial and dorsal edges. There was a clear correlation of topical cartilage degeneration and subchondral density.
In healthy feet, force transmission in the TMT joints appears to occur via the dorsal and medial edges. Considering the correlation of topical cartilaginous surface DMC and subchondral density patterns, clinical application of CT-OAM seems to be recommendable in the case of undefined middle foot pain.
老年个体中不明原因的中足疼痛是一个日益严重的问题。因此，跗跖关节（Lisfranc关节，TMT关节）对足部结构尤为重要。本研究的目的是通过分析关节软骨的退行性形态变化（DMC）和软骨下密度模式来了解TMT关节中的力传递情况。
我们使用了本科解剖课程中的七份福尔马林固定的足部标本（平均年龄80.8岁）。应用柯林斯模式，检查软骨表面DMC的定位。为了显示软骨下密度模式，使用了成熟的CT骨吸收测量法（CT-OAM）。
软骨表面DMC常位于内侧边缘。最大密度区域出现在内侧和背侧边缘。局部软骨退变与软骨下密度之间存在明显的相关性。
在健康足部，TMT关节中的力传递似乎通过背侧和内侧边缘进行。考虑到局部软骨表面DMC与软骨下密度模式的相关性，在不明原因的中足疼痛病例中，CT-OAM的临床应用似乎是可取的。
