Resident Physician, OSF St. Anthony Medical Center Podiatric Residency Program, Rockford, IL.
Attending Physician, OSF St. Anthony Medical Center Podiatric Residency Program, Rockford, IL; Foot and Ankle Surgeon, Orthoillinois Ltd., Rockford, Illinois, Rockford, IL.
J Foot Ankle Surg. 2021 May-Jun;60(3):489-493. doi: 10.1053/j.jfas.2020.05.022. Epub 2020 Sep 21.
The purpose of the present study was to analyze the difference in frontal plane rotation of the entire first ray in patients with and without hallux valgus using standing weightbearing computed tomography (CT). Ten feet of 10 patients with hallux valgus and 36 feet of 36 patients without hallux valgus were examined. Standing weightbearing CT scans and radiographs were taken for all subjects. Frontal plane measurements of the sesamoid apparatus, first metatarsal head, first metatarsal base, and medial cuneiform were performed. Frontal plane rotation of the first tarsometatarsal joint and intrinsic first metatarsal torsion was calculated. An independent 2 sample t test was used to compare means of outcomes of interest across control and treatment groups. Statistical significance was set at an alpha level of 0.05. There was a significant increase in pronation of the sesamoid apparatus (23.49° vs 6.60°) and first metatarsal head (17.79° vs 9.81°) in patients with hallux valgus. There was a significant increase in first metatarsal torsion toward pronation in patients with hallux valgus (22.28° vs 13.52°). No significant difference was detected in the rotation at the first tarsometatarsal joint or the frontal plane orientations of the first metatarsal base and medial cuneiform. By examining the frontal plane position of the entire first ray during weightbearing using standing CT in patients with and without hallux valgus, we determined the level at which pronation originates to be within the first metatarsal bone rather than the first tarsometatarsal joint.
本研究旨在使用站立负重 CT 分析拇外翻患者和无拇外翻患者整个第一跖骨在额状面上的旋转差异。检查了 10 例拇外翻患者的 10 只脚和 36 例无拇外翻患者的 36 只脚。所有受试者均进行站立负重 CT 扫描和 X 线检查。对籽骨装置、第一跖骨头、第一跖骨基底和内侧楔骨进行额状面测量。计算第一跖跗关节和固有第一跖骨扭转的额状面旋转。使用独立两样本 t 检验比较对照组和治疗组感兴趣结局的均值。统计学意义设定为α水平 0.05。拇外翻患者的籽骨装置（23.49° vs 6.60°）和第一跖骨头（17.79° vs 9.81°）的旋前明显增加。拇外翻患者的第一跖骨向旋前扭转明显增加（22.28° vs 13.52°）。第一跖跗关节的旋转或第一跖骨基底和内侧楔骨的额状面方向无显著差异。通过在有和无拇外翻患者站立负重时使用 CT 检查额状面第一跖骨的位置，我们确定旋前的起始水平位于第一跖骨而不是第一跖跗关节。
