Pareja-Esteban J A, García-López M, Pizones-Arce F J, Benito-Martín E, Fernández-Camacho F J, Plasencia-Arriba M A
Acta Ortop Mex. 2013 Sep-Oct;27(5):312-8.
Classical descriptions of the ossification of the first metatarsal bone show the existence of a single proximal secondary ossification nucleus, mimicking the typical ossification of a phalanx. However, there are studies that show the presence of a second distal ossification nucleus and discuss its nature: epiphysis or pseudoepiphysis. The objective of the study is to establish the prevalence of such distal nucleus, determine its role in the growth of the radius and its relation with different qualitative variables.
We conducted a retrospective study that included 971 dorsoplantar images from 225 patients. We analyzed the presence of such nucleus, the age of appearance and closure, the relation with different qualitative variables and their contribution to the longitudinal growth of the first metatarsal bone.
The distal ossification nucleus appears in 40% of all images and in 81.1% of cases ages 4-7 years. Mean age of appearance is 3.07 years, while physeal closure occurs at a mean of 7.67 years. We found a significantly higher frequency of physeal closure in children, patients with Egyptian type foot, flat foot, and index-plus and Egyptian type foot combinations. The definitive length of the first metatarsal bone is greater in patients with a distal ossification nucleus.
We may state the presence of the distal ossification nucleus of the first metatarsal bone that behaves as a fertile growth cartilage.
对第一跖骨骨化的经典描述显示存在单个近端次级骨化核，类似于指骨的典型骨化。然而，有研究表明存在第二个远端骨化核，并讨论了其性质：骨骺或假骨骺。本研究的目的是确定这种远端核的患病率，确定其在第一跖骨生长中的作用及其与不同定性变量的关系。
我们进行了一项回顾性研究，纳入了来自225例患者的971张背跖位图像。我们分析了这种核的存在情况、出现和闭合的年龄、与不同定性变量的关系及其对第一跖骨纵向生长的贡献。
远端骨化核出现在所有图像的40%中，在4至7岁的病例中占81.1%。平均出现年龄为3.07岁，而骨骺闭合平均发生在7.67岁。我们发现儿童、埃及足型患者、扁平足患者以及指数加型和埃及足型组合患者的骨骺闭合频率明显更高。有远端骨化核的患者第一跖骨的最终长度更长。
我们可以确定第一跖骨远端骨化核的存在，其表现为一个活跃的生长软骨。
