影响足内翻畸形患儿主观症状的因素：牛津踝关节-足问卷研究。

Factors Affecting Subjective Symptoms in Children with Pes Planovalgus Deformity: A Study Using the Oxford Ankle Foot Questionnaire.

机构信息

Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea.

Department of Mathematics and Department of AI and Data Science, College of Natural Sciences, Ajou University, Gyeonggi, Republic of Korea.

出版信息

J Bone Joint Surg Am. 2020 Sep 2;102(17):1479-1485. doi: 10.2106/JBJS.19.01504.

DOI:10.2106/JBJS.19.01504

PMID:32590397

Abstract

BACKGROUND

Idiopathic pes planovalgus is one of the most common foot deformities in children and adolescents. However, there is a discrepancy between subjective symptoms and radiographic severity in idiopathic planovalgus deformity, and very few studies have investigated this aspect. Further, the assessment of subjective symptoms in patients with pes planovalgus requires a quantitative scoring system for making meaningful comparisons, such as the Oxford Ankle Foot Questionnaire for Children (OxAFQ-c) and that for parents (OxAFQ-p). Therefore, the purpose of this study was to evaluate the factors affecting the symptoms of idiopathic planovalgus using the OxAFQ.

METHODS

All patients who were ≤18 years of age, had visited our clinic for the evaluation of pes planovalgus deformity, and had completed the OxAFQ were included in this study. The anteroposterior talo-first metatarsal, lateral talo-first metatarsal, and hallux valgus angles were measured on weight-bearing radiographs. The data were analyzed using a multiple regression model, with age, sex, and radiographic indices as explanatory variables.

RESULTS

Overall, 123 patients were enrolled in this study, and 246 standing foot radiographs were evaluated along with scores in each domain of the OxAFQ. The factors affecting physical domain scores in the OxAFQ-c were female sex (p = 0.047) and the anteroposterior talo-first metatarsal angle (p = 0.033). Age of ≥10 years was a significant factor (p < 0.05) affecting all domains in both the OxAFQ-c and OxAFQ-p other than the physical domain score.

CONCLUSIONS

Although pes planovalgus deformity is 3-dimensional, the forefoot abduction component of the deformity should be carefully assessed as it is closely related to subjective symptoms. Further, in female patients with a more severe anteroposterior talo-first metatarsal angle, an aggravation of symptoms with aging should be expected when managing pes planovalgus deformity.

LEVEL OF EVIDENCE

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

摘要

背景

特发性足纵弓塌陷是儿童和青少年最常见的足部畸形之一。然而，特发性扁平足畸形的主观症状与影像学严重程度之间存在差异，且很少有研究对此进行探讨。此外，评估足纵弓塌陷患者的主观症状需要一种定量评分系统，以便进行有意义的比较，例如儿童牛津踝关节-足部问卷（OxAFQ-c）及其家长版（OxAFQ-p）。因此，本研究旨在使用 OxAFQ 评估特发性扁平足症状的影响因素。

方法

所有年龄≤18 岁、因足纵弓畸形就诊且完成 OxAFQ 评估的患者均纳入本研究。在负重位 X 线片上测量距骨-第一跖骨的前后位、距骨-第一跖骨的外侧位和足踇外翻角。使用多元回归模型，以年龄、性别和影像学指标作为解释变量进行数据分析。

结果

本研究共纳入 123 例患者，共评估了 246 份站立位足部 X 线片和 OxAFQ 各领域的评分。OxAFQ-c 中物理领域评分的影响因素为女性（p = 0.047）和距骨-第一跖骨的前后位角（p = 0.033）。≥10 岁的年龄是影响 OxAFQ-c 和 OxAFQ-p 除物理领域评分之外所有领域的显著因素（p < 0.05）。