Catholic University Saint Vincent Martir, Faculty of Medicine, Valencia, Spain.
Central University of Cataluna (VIC), Faculty of Medicine, VIC, Spain.
Sci Rep. 2022 Mar 21;12(1):4789. doi: 10.1038/s41598-022-08805-w.
Painful lesions on the plantar aspect of the first interphalangeal joint (IPJ) of the hallux can be attributed to structures called ossicles, nodules, or sesamoids. The aims of the present study were first to verify that ultrasonography (US) is a high-sensitivity tool for diagnosing an interphalangeal ossicle (IO), and second to prove that US-guided-shaving surgery ("milling") is a safe and feasible technique for remodeling the IO. The study is divided into three parts. In the first part, the prevalence of IOs was estimated in 12 cadaver feet using US, anatomical dissection, and fluoroscopy. In the second, a detailed US and morphological description of the IO was obtained. In the third, six cadaver feet were subjected to surgical milling. IO prevalence was 41.6% in gross anatomy, 41.6% in US examination and just 16.6% in fluoroscopy. The ossicles had a mean length of 4 mm (± 2 mm) and a width of 7 mm (± 2 mm). The ossicles could be completely shaved in all specimens without injuring important anatomical structures. Our results indicate that US is a more precise tool for diagnosing an IO than X-ray. Moreover, our US-guided mini-invasive surgical technique appears feasible and safe.
拇趾近节趾骨间关节（IPJ）跖侧的疼痛性病变可归因于称为小骨、结节或籽骨的结构。本研究的目的首先是验证超声（US）是诊断指间小骨（IO）的高灵敏度工具，其次是证明 US 引导下削磨手术（“铣削”）是一种安全可行的 IO 重塑技术。该研究分为三个部分。在第一部分中，使用 US、解剖学解剖和透视检查估计了 12 具尸体足中 IO 的患病率。在第二部分，获得了 IO 的详细 US 和形态描述。在第三部分，对 6 具尸体足进行了手术铣削。大体解剖中 IO 的患病率为 41.6%，US 检查中为 41.6%，透视检查中仅为 16.6%。小骨的平均长度为 4mm（±2mm），宽度为 7mm（±2mm）。所有标本均能完全削磨小骨而不损伤重要的解剖结构。我们的结果表明，US 是诊断 IO 比 X 射线更精确的工具。此外，我们的 US 引导下微创外科技术似乎是可行且安全的。
