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距骨的三维形态计量学分析:对距下关节运动学变化的影响

Three-dimensional morphometric analysis of the talus: implication for variations in kinematics of the subtalar joint.

作者信息

Nozaki Shuhei, Watanabe Kota, Katayose Masaki

机构信息

Department of Rehabilitation, Obihiro Kyokai Hospital, South-9, East-5, Obihiro, 080-0805, Japan.

Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, South-1, West-17, Chu-Ou-Ku, Sapporo, 060-8556, Japan.

出版信息

Surg Radiol Anat. 2017 Oct;39(10):1097-1106. doi: 10.1007/s00276-017-1851-x. Epub 2017 Apr 4.

Abstract

PURPOSE

Three-dimensional (3D) movement of the clinical subtalar joint (CSTJ) is primarily determined by the morphology of the articular surfaces of the talus. The purposes of this study were to assess the 3D orientation of the CSTJ facets of the talus and the talar head and to determine the tri-axial angular relationship.

METHODS

Fifty dry tali were scanned using computed tomography to create a 3D bone model of the talus. The tri-axial angles of the anterior, middle, and posterior facets and the talar head were calculated. A correlation analysis between the angles of the posterior facet and the talar head was also performed.

RESULTS

The transverse angle at both the posterior facet and the talar head was significantly correlated with the sagittal angle (r = -0.441, p < 0.001; and r = -0.694, p < 0.001, respectively). The sagittal angle of the posterior facet was significantly correlated with that of the talar head (r = 0.478, p < 0.001).

CONCLUSIONS

When the posterior facet of the talus and the talar head exhibits a greater downward and lesser medial orientation, a greater inversion/eversion at the CSTJ should be induced, while an opposite orientation should induce greater plantarflexion/dorsiflexion and medial/lateral rotation at the CSTJ. Our findings will be useful for planning rehabilitation programs and surgical interventions to correct the subtalar joint orientation in clinical settings.

摘要

目的

临床距下关节(CSTJ)的三维(3D)运动主要由距骨关节面的形态决定。本研究的目的是评估距骨CSTJ小关节面和距骨头的三维方向,并确定三轴角度关系。

方法

使用计算机断层扫描对50个干燥距骨进行扫描,以创建距骨的三维骨模型。计算前、中、后小关节面和距骨头的三轴角度。还对后小关节面和距骨头的角度进行了相关性分析。

结果

后小关节面和距骨头的横向角度与矢状角度均显著相关(分别为r = -0.441,p < 0.001;和r = -0.694,p < 0.001)。后小关节面的矢状角度与距骨头的矢状角度显著相关(r = 0.478,p < 0.001)。

结论

当距骨后小关节面和距骨头呈现更大的向下和更小的内侧方向时,CSTJ应诱导更大的内翻/外翻,而相反的方向应在CSTJ诱导更大的跖屈/背屈和内/外旋转。我们的研究结果将有助于规划康复计划和手术干预,以在临床环境中纠正距下关节方向。

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