Chen Li, Wang Chen, Wang Xu, Huang Jiazhang, Zhang Chao, Zhang Yijun, Ma Xin
Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai 200040, China.
Chin Med J (Engl). 2014;127(11):2067-72.
A causal link between the metatarsus adductus and hallux valgus is not clear. The aim of this study was to investigate the configurations of the metatarsus adductus deformity by radiological measurements and reappraise the relationship between hallux valgus and metatarsus adductus.
The first step was evaluation of the relationship between metatarsus adductus and hallux valgus on 143 dorsoplantar weight-bearing radiographs diagnosed as hallux valgus which was also known as bunions. Measurements including the hallux valgus angle (HVA), the intermetatarsal angle (IMA), the Kilmartin angle (KA), the tibial sesamoid position (TSP), and metatarsus adductus angle were taken. The metatarsus adductus angle is defined by Sgarlato's angle (SMA) and Engel's angle (EMA) respectively.
The metatarsus adductus angle positively correlates with the HVA (r = 0.590, P = 0.000) and KA (r = 0.601, P = 0.000), yet negatively correlates with the grade of TSP, (r = -0.348, P = 0.000). Contradiction of diagnosis existed in 22 (22/100) subjects diagnosed as metatarsus adductus by SMA yet normal by EMA. In this group, the correlation between HVA and metatarsus adductus angle was negative (r = -0.472, P = 0.027).
EMA and SMA defined metatarsus adductus by different deformity apexes. Metatarsus adductus configurations in that the apex of the deformity lay in either the base of metatarsals or tarsus. They respectively correlate positively or negatively to the HVA.
跖骨内收与拇外翻之间的因果关系尚不清楚。本研究的目的是通过影像学测量来研究跖骨内收畸形的形态，并重新评估拇外翻与跖骨内收之间的关系。
第一步是在143张诊断为拇外翻（也称为拇囊炎）的背侧负重X线片上评估跖骨内收与拇外翻之间的关系。测量包括拇外翻角（HVA）、跖间角（IMA）、基尔马丁角（KA）、胫侧籽骨位置（TSP）和跖骨内收角。跖骨内收角分别由斯加拉托角（SMA）和恩格尔角（EMA）定义。
跖骨内收角与HVA（r = 0.590，P = 0.000）和KA（r = 0.601，P = 0.000）呈正相关，但与TSP分级呈负相关（r = -0.348，P = 0.000）。在22名（22/100）被SMA诊断为跖骨内收但EMA检查正常的受试者中存在诊断矛盾。在该组中，HVA与跖骨内收角之间的相关性为负（r = -0.472，P = 0.027）。
EMA和SMA通过不同的畸形顶点定义跖骨内收。跖骨内收形态表现为畸形顶点位于跖骨基部或跗骨。它们分别与HVA呈正相关或负相关。
