距下关节表面分型与扁平足畸形的相关性：哪种类型更易导致扁平足畸形。
Association between subtalar articular surface typing and flat foot deformity: which type is more likely to cause flat foot deformity.
机构信息
Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, China.
Center for Orthopedic Diseases Research, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, China.
出版信息
BMC Musculoskelet Disord. 2021 Nov 23;22(1):979. doi: 10.1186/s12891-021-04872-8.
BACKGROUND
Previous studies have shown a wide range of anatomical classifications of the subtalar joint (STJ) in the population and this is related to the different force line structures of the foot. Different subtalar articular surface morphology may affect the occurrence and development of flat foot deformity, and there are fewer studies in this area. The main objective of our study was to determine the association of different subtalar articular surface with the occurrence and severity of flat foot deformity.
METHODS
We analyzed the imaging data of 289 cases of STJ. The articular surface area, Gissane's angle and Bohler's angle of subtalar articular surface of different types were counted. The occurrence and severity of flat foot deformity in different subtalar articular surface were judged by measuring the Meary angle of foot.
RESULTS
We classified 289 cases of subtalar articular surface into five types according to the morphology. According to Meary angle, the flat foot deformity of Type I and Type IV are significantly severer than Type II (P < 0.05). Type II (7.65 ± 1.38 cm) was significantly smaller than Type I (8.40 ± 1.79 cm) in the total joint facet area(P < 0.05). Type III (9.15 ± 1.92 cm) was smaller than Type I (8.40 ± 1.79 cm), II (7.65 ± 1.38 cm) and IV (7.81 ± 1.74 cm) (P < 0.05). Type II (28.81 ± 7.44) was significantly smaller than Type I (30.80 ± 4.61 degrees), and IV (32.25 ± 5.02 degrees) in the Bohler's angle (P < 0.05). Type II (128.49 ± 6.74 degrees) was smaller than Type I (131.58 ± 7.32 degrees), and IV (131.94 ± 5.80 degrees) in the Gissane's angle (P < 0.05).
CONCLUSIONS
After being compared and analyzed the measurement of morphological parameters, joint facet area and fusion of subtalar articular surface were closely related to the severity of flat foot deformity and Type I and IV were more likely to develop severer flat foot deformity.
LEVEL OF EVIDENCE
Level III, retrospective comparative study.
背景
先前的研究表明，人群中存在广泛的距下关节（STJ）解剖分类，这与足部不同的力线结构有关。不同的距下关节表面形态可能会影响平足畸形的发生和发展，而这方面的研究较少。我们研究的主要目的是确定不同距下关节表面与平足畸形的发生和严重程度的关系。
方法
我们分析了 289 例 STJ 的影像学资料。对不同类型的距下关节表面的关节面面积、Gissane 角和 Bohler 角进行计数。通过测量足 Meary 角来判断不同距下关节表面平足畸形的发生和严重程度。
结果
根据形态学将 289 例距下关节表面分为五型。根据 Meary 角，I 型和 IV 型平足畸形明显比 II 型严重（P<0.05）。II 型（7.65±1.38cm）的总关节面面积明显小于 I 型（8.40±1.79cm）（P<0.05）。III 型（9.15±1.92cm）小于 I 型（8.40±1.79cm）、II 型（7.65±1.38cm）和 IV 型（7.81±1.74cm）（P<0.05）。II 型（28.81±7.44）的 Bohler 角明显小于 I 型（30.80±4.61 度）和 IV 型（32.25±5.02 度）（P<0.05）。II 型（128.49±6.74 度）的 Gissane 角小于 I 型（131.58±7.32 度）和 IV 型（131.94±5.80 度）（P<0.05）。
结论
对形态参数的测量进行比较分析后发现，关节面面积和距下关节融合与平足畸形的严重程度密切相关，I 型和 IV 型更易发生严重的平足畸形。
证据等级
III 级，回顾性比较研究。
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