Solomin Leonid N, Ukhanov Konstantin A, Kirienko Alexander P, Herzenberg John E
Surgeon, Vreden Russian Research Institute of Traumatology and Orthopedics, Ministry of Health of Russia, St. Petersburg, Russia; Surgeon, Department of General Surgery, St. Petersburg State University, St. Petersburg, Russia.
Surgeon, Vreden Russian Research Institute of Traumatology and Orthopedics, Ministry of Health of Russia, St. Petersburg, Russia.
J Foot Ankle Surg. 2019 Sep;58(5):865-869. doi: 10.1053/j.jfas.2018.12.025.
Currently available methods for analysis and planning of post-traumatic or congenital deformity correction of the foot have some limitations. The aim of this retrospective study was to establish reference lines and angles (RLAs), and the resulting ratios, based on reproducible anatomic points on sagittal feet radiographs. The key starting point of our evaluation was the previously undescribed length and position of the talus joint line (TJL), from the border of the articular surface of the talus and the posterior process of talus. First, we calculated the relationships between the TJL and the axes of the foot, particularly the anatomic and mechanical lateral talometatarsal angle axes of the first metatarsal. Then, we assessed the relationships with the calcaneus, particularly the lateral heel angle. Finally, we calculated the parameters (angles and coefficients k) derived from the TJL and the foot-bearing points (foot quadrilateral). A total of 64 normal radiographs from 55 patients were analyzed. The values that resulted are as follows: anatomic lateral talometatarsal angle = 28.5° ± 4.5°, mechanical lateral talometatarsal angle = 23.6° ± 3.2°, lateral heel angle = 15.2° ± 3.4°, foot quadrilateral: abc = 144.6° ± 9.4°, bcd = 31.3° ± 2.6°, cda = 79.2° ± 9.8°, dab = 105.0° ± 8.3°, k1 = 3.09 ± 0.4, k2 = 3.77 ± 0.78, and k3 = 1.56 ± 0.24. Sagittal plane reference lines and angles are proposed, providing quantitative values for reference. These parameters have the potential to be easily implemented in foot deformity analysis and correction planning.
目前用于足创伤后或先天性畸形矫正分析与规划的现有方法存在一些局限性。这项回顾性研究的目的是基于矢状位足部X线片上可重复的解剖学点，建立参考线和角度（RLAs）以及由此得出的比率。我们评估的关键起始点是距骨关节线（TJL）从前述未描述的距骨关节面边界和距骨后突的长度和位置。首先，我们计算了TJL与足部轴线之间的关系，特别是第一跖骨的解剖学和力学外侧距骨 - 跖骨角轴线。然后，我们评估了与跟骨的关系，特别是外侧足跟角。最后，我们计算了从TJL和足部支撑点（足部四边形）得出的参数（角度和系数k）。共分析了来自55例患者的64张正常X线片。得出的值如下：解剖学外侧距骨 - 跖骨角 = 28.5°±4.5°，力学外侧距骨 - 跖骨角 = 23.6°±3.2°，外侧足跟角 = 15.2°±3.4°，足部四边形：abc = 144.6°±9.4°，bcd = 31.3°±2.6°，cda = 79.2°±9.8°，dab = 105.0°±8.3°，k1 = 3.09±0.4，k2 = 3.77±0.78，k3 = 1.56±0.24。提出了矢状面参考线和角度，提供了可供参考的定量值。这些参数有可能在足部畸形分析和矫正规划中轻松应用。
