Koller Ulrich, Willegger Madeleine, Windhager Reinhard, Wanivenhaus Axel, Trnka Hans-Joerg, Schuh Reinhard
Department of Orthopaedics, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
J Orthop Res. 2014 Dec;32(12):1688-93. doi: 10.1002/jor.22707. Epub 2014 Aug 11.
Due to the pathoanatomical changes in hallux valgus feet, the plantar flexion moment of the first metatarsophalangeal joint is reduced. Therefore, load bearing of the hallux is decreased during push-off. We assessed loading parameters in hallux valgus feet. Based on dorsal-plantar weight bearing radiographs of 61 feet, the intermetatarsal-, hallux valgus-, distal metatarsal articulation-angle, and sesamoid position were evaluated. Plantar pressure assessment was performed with the emed® system during level walking. We found negative correlations between hallux valgus angle and peak pressure in the great toe (r=-0.301, p<0.023), the maximum force of the hallux (r=-0.481, p<0.001), and contact time of the great toe (r=-0.448, p<0.001), and positive correlations for force time integral (r=0.348, p<0.001), contact area (r=0.307, p<0.020), maximum force (r=0.430, p<0.001), and peak pressure (r=0.361, p<0.006) of the fifth metatarsal head. A positive correlation between the sesamoid and the metatarsal subluxation regarding maximum force (r=0.294, p<0.034), and a negative correlation between the contact area of the hallux (r=-0.232, p<0.020) was shown. Depending on the severity, hallux valgus angle, and sesamoid subluxation, load shows significant lateral transmission in hallux valgus feet.
由于拇外翻足的病理解剖变化,第一跖趾关节的跖屈力矩减小。因此,在蹬离期拇趾的承重减少。我们评估了拇外翻足的负荷参数。基于61只足的背-底负重位X线片,评估了跖间角、拇外翻角、远侧跖骨关节角和籽骨位置。在平地行走时使用emed®系统进行足底压力评估。我们发现拇外翻角与拇趾的峰值压力(r=-0.301,p<0.023)、拇趾的最大力(r=-0.481,p<0.001)以及拇趾的接触时间(r=-0.448,p<0.001)呈负相关,与第五跖骨头的力-时间积分(r=0.348,p<0.001)、接触面积(r=0.307,p<0.020)、最大力(r=0.430,p<0.001)和峰值压力(r=0.361,p<0.006)呈正相关。籽骨与跖骨半脱位在最大力方面呈正相关(r=0.294,p<0.034),拇趾的接触面积呈负相关(r=-0.232,p<0.020)。根据严重程度、拇外翻角和籽骨半脱位情况,拇外翻足的负荷显示出明显的外侧传递。