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踝关节和足部的运动学。体内X线立体摄影测量法。

Kinematics of the ankle and foot. In vivo roentgen stereophotogrammetry.

作者信息

Lundberg A

机构信息

Department of Orthopedics, Karolinska Hospital, Stockholm, Sweden.

出版信息

Acta Orthop Scand Suppl. 1989;233:1-24. doi: 10.1186/1757-1146-5-s1-k5.

DOI:10.1186/1757-1146-5-s1-k5
PMID:2686345
Abstract

Roentgen stereophotogrammetric analysis has been used to study ankle/foot kinematics in eight healthy volunteers. All the joints between the tibia and the first metatarsal as well as the talo-calcaneal and tibio-fibular joints were analysed in input plantar flexion/dorsiflexion and pronation/supination of the foot as well as internal/external rotation of the leg. The findings included the following: INDIVIDUAL JOINTS 1. The joint axis of the talo-crural joint varied with varying kinds of input motion. Substantial amounts of rotation occurred about axes close to the vertical; this occurred particularly when the input motion was in the internal rotation part of the arc of leg rotation and in pro-/supination of the foot. 2. The total amount of rotation in the talo-calcaneal joint was small in internal rotation of the leg and in pronation of the foot compared to external rotation of the leg and supination of the foot. 3. The talo-navicular joint showed a limited ball-and-socket joint pattern in all subjects. The total amounts of rotation were larger than in the talo-calcaneal joint in all subjects. Plantar flexion axes were more transverse than the axes seen in other kinds of input motion. 4. The talo-calcaneal and talo-navicular joint axes were seldom parallel, indicating that these joints do not necessarily behave as a simple hinge. JOINT INTERACTION Joint interaction varied in different qualities of input motion. Plantar flexion induced rotation in the talo-crural joint, and to some extent in the joints of the arch. Dorsiflexion mainly induced talo-crural joint motion. Pronation/supination induced motion in all joints. The distal joints of the arch displayed more rotation in pronation than in supination, while the talo-calcaneal joint showed less motion in pronation than in supination. Internal leg rotation induced little rotation in the joints of the ankle/foot complex. External rotation induced external rotation, dorsiflexion, and supination in the talo-navicular and talo-calcaneal joints. The distal joints of the arch displayed compensatory plantar flexion and pronation. TRANSFERRAL OF ROTATION The ankle/foot complex showed ability to transform leg rotation into pro-/supination and vice versa. This function was most pronounced in external leg rotation. MOTIONS OF THE FIBULA The fibula showed consistent lateral and posterior translation from input plantar flexion to dorsiflexion of the foot.

摘要

采用X线立体摄影测量分析技术对8名健康志愿者的踝/足运动学进行了研究。在足部进行跖屈/背屈、内翻/外翻以及小腿内旋/外旋时,对胫骨与第一跖骨之间的所有关节以及距下关节和胫腓关节进行了分析。研究结果如下:

  • 单个关节

    1. 距小腿关节的关节轴随输入运动类型的不同而变化。围绕接近垂直的轴发生了大量旋转;当输入运动处于小腿旋转弧的内旋部分以及足部的内翻/外翻时,这种情况尤为明显。
    1. 与小腿外旋和足部外翻相比,小腿内旋和足部内翻时距下关节的总旋转量较小。
    1. 在所有受试者中,距舟关节呈现出有限的球窝关节模式。所有受试者中其总旋转量均大于距下关节。跖屈轴比其他输入运动时的轴更具横向性。
    1. 距下关节和距舟关节的关节轴很少平行,这表明这些关节不一定表现为简单的铰链关节。
  • 关节相互作用

  • 关节相互作用在不同质量的输入运动中有所不同。跖屈会导致距小腿关节以及在一定程度上足弓关节发生旋转。背屈主要导致距小腿关节运动。内翻/外翻会使所有关节发生运动。足弓的远端关节内翻时的旋转比外翻时更多,而距下关节内翻时的运动比外翻时更少。小腿内旋在踝/足复合体的关节中引起的旋转很少。小腿外旋会导致距舟关节和距下关节发生外旋、背屈和外翻。足弓的远端关节会出现代偿性跖屈和内翻。

  • 旋转传递

  • 踝/足复合体显示出将小腿旋转转化为内翻/外翻以及反之亦然的能力。这种功能在小腿外旋时最为明显。

  • 腓骨的运动

  • 从足部的输入跖屈到背屈,腓骨呈现出一致的向外侧和后方平移。

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