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自然全负重站立对第一跖骨旋转的影响。

Effect of natural full weight-bearing during standing on the rotation of the first metatarsal bone.

机构信息

Department of Orthopedic Surgery, Keio University, Tokyo, Japan.

Department of Radiology, Keio University, Tokyo, Japan.

出版信息

Clin Anat. 2019 Jul;32(5):715-721. doi: 10.1002/ca.23385. Epub 2019 Apr 29.

DOI:10.1002/ca.23385
PMID:30989741
Abstract

To evaluate the rotational change in the first metatarsal bone (1MT) of the foot during natural standing using an upright computed tomography (CT) scanner with 320-detector rows. A total of 52 feet of 28 asymptomatic subjects (aged 23-39 years) were evaluated in the natural standing position with or without weight-bearing. A foot pressure plate was used to determine the non-weight-bearing (NWB) or single leg full-weight-bearing (s-FWB) conditions. CT examinations were performed using a noise index of 15 for a slice thickness of 5 mm, rotation speed of 0.5 sec, and slice thickness of 0.5 mm. The rotation of the 1MT was measured on the coronal CT image, which cut the sesamoids' bellies in the frontal slide of the first metatarsal and sesamoids perpendicular to the longitudinal bisection of the third metatarsal, and compared between the weight-bearing conditions. Intra- and inter-observer reliabilities of the rotation angle were also evaluated. The intra- and inter-observer correlation coefficients were 0.961 and 0.934, respectively. The 1MT pronation angle was significantly greater in the s-FWB condition than in the NWB condition (15.2° ± 5.4° vs. 12.5° ± 5.3°, P < 0.01). No sex difference was found in the magnitude of the 1MT pronation angle as a result of weight-bearing. This study first demonstrated that pronation of 1MT occurs due to natural full-weight-bearing in asymptomatic feet. The 1MT's rotational movement under weight-bearing conditions may relate to the onset and pathogenesis of the hallux valgus. Clin. Anat. 32:715-721, 2019. © 2019 Wiley Periodicals, Inc.

摘要

利用具有 320 个探测器排的直立式计算机断层扫描(CT)扫描仪评估足部第一跖骨(1MT)在自然站立时的旋转变化。共评估了 28 名无症状受试者(年龄 23-39 岁)的 52 只脚,这些脚在自然站立位分别处于无负重和单腿全负重两种状态。使用足底压力板来确定无负重(NWB)或单腿全负重(s-FWB)条件。CT 检查的噪声指数为 15,层厚为 5mm,旋转速度为 0.5 秒,层厚为 0.5mm。在冠状 CT 图像上测量 1MT 的旋转,该图像在第一跖骨的额状面切穿籽骨的腹部,并与第三跖骨的纵切面垂直切穿籽骨,然后比较负重状态下的旋转角度。还评估了旋转角度的观察者内和观察者间可靠性。旋转角度的观察者内和观察者间相关系数分别为 0.961 和 0.934。在 s-FWB 条件下,1MT 旋前角度明显大于 NWB 条件(15.2°±5.4°比 12.5°±5.3°,P<0.01)。负重对 1MT 旋前角度大小无性别差异。本研究首次表明,1MT 的旋前是由于无症状足的自然全负重引起的。负重条件下 1MT 的旋转运动可能与拇外翻的发病机制有关。临床解剖学 32:715-721,2019。©2019 年 Wiley 期刊公司

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