Hoffmeyer P, Cox J N, Blanc Y, Meyer J M, Taillard W
Hôpital Cantonal Universitaire, Geneva, Switzerland.
Clin Orthop Relat Res. 1988 Jul(232):112-8.
Muscle imbalance is cited widely as a major factor in the production of hallux valgus deformity. The authors, therefore, performed muscle biopsies in 57 patients (53 women and four men; average age, 45.3 years) to examine the histology and ultrastructure of the intrinsic muscles about the great toe. The biopsy study was correlated with gait analysis. In 53 biopsy specimens the muscles were found to be histologically abnormal, presenting myogenic and neurogenic alterations. Furthermore, ultrastructural examination showed enlarged mitochondria with paracrystalline inclusions in 31 of the 57 cases. Gait analysis showed an abnormal rollover pattern in 70% of the gait cycles examined in 19 symptomatic hallux valgus patients (18 women and one man), while in 19 asymptomatic volunteers (16 women and three men) 80% of the cycles examined were normal. The surface electromyographic (EMG) activity of the intrinsic muscles also was abnormal in the patient group when compared with the volunteer group; five different patterns of electrical activity were found. These findings may be interpreted as a result of chronic ischemia caused by the elevated pressure occurring within the foot during gait.
肌肉失衡被广泛认为是拇外翻畸形产生的主要因素。因此，作者对57例患者（53名女性和4名男性；平均年龄45.3岁）进行了肌肉活检，以检查拇趾周围固有肌肉的组织学和超微结构。活检研究与步态分析相关。在53个活检标本中，发现肌肉组织学异常，呈现肌源性和神经源性改变。此外，超微结构检查显示，57例中有31例线粒体增大并伴有类晶体包涵体。步态分析显示，在19例有症状的拇外翻患者（18名女性和1名男性）中，70%的步态周期存在异常翻转模式，而在19名无症状志愿者（16名女性和3名男性）中，80%的检查周期正常。与志愿者组相比，患者组固有肌肉的表面肌电图（EMG）活动也异常；发现了五种不同的电活动模式。这些发现可能被解释为步态期间足部压力升高导致慢性缺血的结果。
