Verdu Roman Carmen, Martinez Gimenez Enrique, Bustamante Suarez de Puga David, Mas Martinez Jesus, Morales Santias Manuel, Sanz-Reig Javier
Foot and Ankle Unit, Department of Orthopaedic Surgery, Clinica HLA Vistahermosa, Av de Denia 76. 03016. Alicante, Spain.
Indian J Orthop. 2021 May 19;55(Suppl 2):436-444. doi: 10.1007/s43465-021-00416-3. eCollection 2021 Jul.
Few previous studies focused on plantar loading patterns in HV patients with metatarsalgia. Are there any differences in plantar pressure measurements in women with HV with and without metatarsalgia?
A prospective matched-cohort study was designed to analyze plantar pressure measurements in women with HV with and without metatarsalgia from January 2017 to December 2019. The inclusion criteria were age over 18 years old, women, diagnosis of HV with metatarsalgia. Control group had the same inclusion criteria, except metatarsalgia. Patient-reported outcomes scores included American Orthopedic Foot and Ankle Society Score (AOFAS), and Visual Analog Scale (VAS). Radiographic data were obtained according to the guidelines of the AOFAS Committee on Angular Measurements. Plantar pressure measurements were performed using a platform.
Forty-seven patients met the inclusion criteria. An age-, BMI-, and hallux valgus angle-matched cohort of 47 patients were also selected. There were no statistically significant differences in demographic data and radiographic assessment. HV with metatarsalgia group showed greater values in peak and mean force, peak and mean pressure, and pressure-time integral under toes and metatarsal heads. These differences reached statistically significant in mean force ( = 0.009) and peak force ( = 0.003) under T1; mean pressure ( = 0.01) and peak pressure ( = 0.04) under T1; and mean force ( = 0.003) under MH1. The binary logistic regression analysis showed mean force under T1 as the most associated plantar pressure measurement with the presence of metatarsalgia. C-statistic was 0.66. Mean force > 35 N had a 70% of sensitivity and a 57% of specificity as a cut-off value for the presence of metatarsalgia.
HV patients with metatarsalgia had greater values in plantar pressure measurements. Mean force under T1 could be used as a plantar pressure measurement to predict metatarsalgia.
既往很少有研究关注患有跖痛症的拇外翻（HV）患者的足底负荷模式。患有和未患有跖痛症的女性拇外翻患者在足底压力测量方面是否存在差异？
设计了一项前瞻性匹配队列研究，以分析2017年1月至2019年12月患有和未患有跖痛症的女性拇外翻患者的足底压力测量情况。纳入标准为年龄超过18岁、女性、诊断为患有跖痛症的拇外翻。对照组具有相同的纳入标准，但不包括跖痛症。患者报告的结局评分包括美国矫形足踝协会评分（AOFAS）和视觉模拟量表（VAS）。根据AOFAS角度测量委员会的指南获取影像学数据。使用平台进行足底压力测量。
47例患者符合纳入标准。还选择了47例年龄、体重指数和拇外翻角度匹配的队列。人口统计学数据和影像学评估无统计学显著差异。患有跖痛症的拇外翻组在脚趾和跖骨头下方的峰值力和平均力、峰值压力和平均压力以及压力-时间积分方面显示出更高的值。这些差异在T1下方的平均力（P = 0.009）和峰值力（P = 0.003）；T1下方的平均压力（P = 0.01）和峰值压力（P = 0.04）；以及MH1下方的平均力（P = 0.003）方面达到统计学显著。二元逻辑回归分析显示T1下方的平均力是与跖痛症存在最相关的足底压力测量指标。C统计量为0.66。平均力> 35 N作为跖痛症存在的截断值时，敏感性为70%，特异性为57%。
患有跖痛症的拇外翻患者足底压力测量值更高。T1下方的平均力可作为预测跖痛症的足底压力测量指标。
