Orthopedic Surgeon, Vreden Russian Research Institute of Traumatology and Orthopedics, Ministry of Health of Russia, St. Petersburg, Russia; Orthopedic Surgeon, Department of General Surgery, St. Petersburg State University, St. Petersburg, Russia.
Orthopedic Surgeon, Vreden Russian Research Institute of Traumatology and Orthopedics, Ministry of Health of Russia, St. Petersburg, Russia.
J Foot Ankle Surg. 2020 Jul-Aug;59(4):774-780. doi: 10.1053/j.jfas.2019.11.003. Epub 2020 Apr 10.
The aim of this study was to test a novel planning method for midfoot deformity correction, based on reference lines and angles (RLA) of talus and first metatarsal of 64 normal radiographs from 55 patients. The anatomic lateral talometatarsal angle (aLTMA), resulting from the intersection of talus joint line (TJL), from the border of the articular surface of the talus to the posterior process of talus, and the anatomic axis of the first metatarsal, was 28.5° ± 4.5°. The intersection of those 2 lines divided the TJL in 2 segments (ac and ab) with the ratio k1 = 0.7 ± 0.3. The length of the first metatarsal line was measured from its intersection with the TJL and first metatarsal head, and it was 3.6 times longer that of the TJL (k2). To analyze foot deformity, we propose to draw the TJL line as follows. Use the k1 ratio to determine the point where the aLMTA intersects the TJL. From this point, an idealized anatomic first metatarsal line should be drawn, at 28.5° from the TJL. The distal end of that line is based on the k2 ratio (3.6 × TJL length). Next, the actual anatomic lateral talometatarsal line of the deformed foot is drawn. The intersection between these 2 lines identifies the apex and magnitude of the deformity. Deformity correction planning using the proposed method was demonstrated and confirmed in 2 cases. A reference method for analysis and planning of midfoot sagittal plane deformity correction independent of foot position relative to the ankle joint or the presence of concomitant hindfoot deformity appears promising for future investigation and use.
本研究旨在测试一种新的足中部畸形矫正规划方法，该方法基于 55 名患者的 64 例正常 X 光片的距骨和第一跖骨的参考线和角度（RLA）。距骨关节线（TJL）与距骨后突的交点与第一跖骨解剖轴形成的解剖外侧距骨角（aLTMA）为 28.5°±4.5°。这两条线的交点将 TJL 分为两段（ac 和 ab），比值 k1=0.7±0.3。从 TJL 与第一跖骨头的交点到第一跖骨线的长度为其长度的 3.6 倍（k2）。为了分析足畸形，我们建议如下绘制 TJL 线。使用 k1 比值确定 aLMTA 与 TJL 的交点。从该点开始，应画出与 TJL 成 28.5°角的理想化解剖第一跖骨线。该线的末端基于 k2 比值（3.6×TJL 长度）。接下来，画出畸形足的实际解剖外侧距骨线。这两条线的交点确定了畸形的顶点和程度。在 2 例患者中演示并证实了使用该方法进行畸形矫正规划。一种独立于踝关节位置或伴发后足畸形的分析和规划矢状面足中部畸形的参考方法具有很大的研究和应用前景。
