Department of Podiatry, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, 3086 Australia.
J Foot Ankle Res. 2010 Sep 16;3:20. doi: 10.1186/1757-1146-3-20.
The severity of hallux valgus is easily appreciated by its clinical appearance, however x-ray measurements are also frequently used to evaluate the condition, particularly if surgery is being considered. There have been few large studies that have assessed the validity of these x-ray observations across a wide spectrum of the deformity. In addition, no studies have specifically focused on older people where the progression of the disorder has largely ceased. Therefore, this study aimed to explore relationships between relevant x-ray observations with respect to hallux valgus severity in older people.
This study utilised 402 x-rays of 201 participants (74 men and 127 women) aged 65 to 94 years. All participants were graded using the Manchester Scale - a simple, validated system to grade the severity of hallux valgus - prior to radiographic assessment. A total of 19 hallux valgus-related x-ray observations were performed on each set of x-rays. These measurements were then correlated with the Manchester Scale scores.
Strong, positive correlations were identified between the severity of hallux valgus and the hallux abductus angle, the proximal articular set angle, the sesamoid position and congruency of the first metatarsophalangeal joint. As hallux valgus severity increased, so did the frequency of radiographic osteoarthritis of the first metatarsophalangeal joint and a round first metatarsal head. A strong linear relationship between increased relative length of the first metatarsal and increased severity of hallux valgus was also observed.
Strong associations are evident between the clinical appearance of hallux valgus and a number of hallux valgus-related x-ray observations indicative of structural deformity and joint degeneration. As it is unlikely that metatarsal length increases as a result of hallux valgus deformity, increased length of the first metatarsal relative to the second metatarsal may be a contributing factor to the development and/or progression of hallux valgus.
拇外翻的严重程度可以通过其临床表现轻松评估，但也经常使用 X 射线测量来评估病情，特别是在考虑手术时。很少有大型研究评估过这种 X 射线观察在广泛的畸形范围内的有效性。此外，尚无专门针对畸形进展基本停止的老年人的研究。因此，本研究旨在探讨与老年人拇外翻严重程度相关的 X 射线观察结果之间的关系。
本研究利用了 201 名年龄在 65 至 94 岁的参与者的 402 张 X 光片（74 名男性和 127 名女性）。所有参与者在进行放射学评估之前都使用 Manchester 量表（一种简单、经过验证的拇外翻严重程度分级系统）进行分级。在每一组 X 光片上都进行了 19 项与拇外翻相关的 X 射线观察。然后将这些测量值与 Manchester 量表评分相关联。
拇外翻严重程度与拇趾外展角、近节跖骨关节面角、籽骨位置和第一跖趾关节吻合度之间存在强烈的正相关关系。随着拇外翻严重程度的增加，第一跖趾关节的放射学骨关节炎和圆形的第一跖骨头的发生率也随之增加。第一跖骨相对长度增加与拇外翻严重程度增加之间也存在强烈的线性关系。
拇外翻的临床表现与许多拇外翻相关的 X 射线观察结果之间存在明显的关联，这些结果表明存在结构畸形和关节退变。由于第一跖骨长度不太可能因拇外翻畸形而增加，因此第一跖骨相对于第二跖骨的长度增加可能是拇外翻发展和/或进展的一个促成因素。
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