Zuo Jian-Gang, Hu Hai-Wei, Sang Zhi-Cheng, Wen Jian-Min, Sun Wei-Dong, Sun Yong-Sheng, Cheng Ting
Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China.
Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China;
Zhongguo Gu Shang. 2017 Jan 25;30(1):51-56. doi: 10.3969/j.issn.1003-0034.2017.01.012.
To analyze the correlation between the hallux valgus angle and arch X-ray parameters change, plantar pressure by measuring the X-ray indexes and foot-pressure indexes in patients with hallux valgus, as well as to study the main cause factors for the pain under the second metatarsal head.
A retrospective study of 254 patients(477 feet) treated in Wangjing Hospital from January 2012 to June 2013 was performed. The pain under the second metatarsal head and age distribution were recorded. All the patients were divided into two groups according to the second plantar bone pain: pain group and no pain group. The following indexes were measured and compared: HAVA(hallux abductor valgus angle), IMA1-2(the inter-metatarsal angle between the first and second metatarsals), IMA1-5(the inter-metatarsal angle between the first and fifth metatarsals), TAOTMLA (top angle of the medial longitudinal arch), AAOTMLA (anterior angle of the medial longitudinal arch), SMRL (the second metatarsal relative length than the first), and the plantar pressure indicators including TPUM (touch the ground time percentage under the second metatarsal head), PPUM (peak pressure under the second metatarsal head), and IUM(impulse under the second metatarsal head). All the factors were evaluated by Logistic regression analysis.
Spearman rank correlation test showed that there were statistical significance in correlation between HAVA and IMA1-2, IMA1-5, TAOTMLA, AAOTMLA, TPUM(<0.05, r=0.647, 0.553, 0.127, -0.165, 0.158). Factors including the HAVA, SMRL and the TPUM were the risks for the pain under the second metatarsal head in patients with hallux valgus(<0.05, ORj=1.030, 1.069, 1.060).
Increase of the hallux valgus angle causes the collapse of hallux valgus arch, extending the weight bearing time of the second metatarsal and increasing the possibility of the pain under the second metatarsal.
通过测量拇外翻患者的X线指标和足底压力指标，分析拇外翻角度与足弓X线参数变化、足底压力之间的相关性，并探讨第二跖骨头下疼痛的主要影响因素。
对2012年1月至2013年6月在望京医院接受治疗的254例患者（477足）进行回顾性研究。记录第二跖骨头下疼痛情况及年龄分布。根据第二跖骨头下疼痛情况将所有患者分为两组：疼痛组和无疼痛组。测量并比较以下指标：拇外翻角（HAVA）、第一与第二跖骨间角（IMA1-2）、第一与第五跖骨间角（IMA1-5）、内侧纵弓顶角（TAOTMLA）、内侧纵弓前角（AAOTMLA）、第二跖骨与第一跖骨相对长度（SMRL），以及足底压力指标，包括第二跖骨头下触地时间百分比（TPUM）、第二跖骨头下峰值压力（PPUM）、第二跖骨头下冲量（IUM）。采用Logistic回归分析对所有因素进行评估。
Spearman等级相关检验显示，HAVA与IMA1-2、IMA1-5、TAOTMLA、AAOTMLA、TPUM之间的相关性具有统计学意义（<0.05，r=0.647、0.553、0.127、-0.165、0.158）。HAVA、SMRL和TPUM等因素是拇外翻患者第二跖骨头下疼痛的危险因素（<0.05，ORj=1.030、1.069、1.060）。
拇外翻角度增加导致拇外翻足弓塌陷，延长第二跖骨的负重时间，增加第二跖骨头下疼痛的可能性。
