Nozaki Shuhei, Watanabe Kota, Katayose Masaki, Yamatsu Kenta, Teramoto Atsushi, Ogihara Naomichi
Laboratory of Human Evolutionary Biomechanics, Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan.
Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Hokkaido 060-8556, Japan.
Ann Anat. 2023 Apr;247:152053. doi: 10.1016/j.aanat.2023.152053. Epub 2023 Jan 22.
The present study aimed to clarify the morphological patterns of the calcaneus and talus that are associated with hallux valgus angle (HVA) by quantifying the differences in the hindfoot bone morphology between left and right sides in HV patients with clear bilateral difference of HVA.
Three-dimensional (3D) computed tomography scans of 32 feet of 16 patients with HV who had right-to-left HVA differences of more than 5 degrees (68.8 ± 8.6 years) were enrolled, and 3D surface models of the calcaneus and talus were generated. A total of 556 and 430 landmarks were placed on the calcaneal and talar surfaces, respectively, to calculate the principal components (PCs) of shape variations. The PC scores were compared between the small and large HVA sides within an individual.
The calcaneus in patients with a larger HVA (mean, 43.2 degrees) possessed slender calcaneal tuberosity, more medially oriented posterior articular surface in the coronal plane, and narrower and more concave anterior-middle articular surfaces compared to those with a small HVA (mean, 33.7 degrees). The talus with a larger HVA exhibited more medially oriented talar head in the transverse plane and more anteriorly protruded lateral region of the talar head compared to the small HVA.
The morphological patterns of the calcaneus in patients with a larger HVA allows the hindfoot bones to easily rotate in the everting direction, while those of the talus could induce a larger internal rotation of the first metatarsal. These morphological patterns of the calcaneus and talus could be structural factors affecting the HV.
本研究旨在通过量化拇外翻角（HVA）存在明显双侧差异的拇外翻（HV）患者左右侧后足骨形态的差异，阐明与拇外翻角相关的跟骨和距骨的形态模式。
纳入16例HV患者的32只脚，这些患者的左右HVA差异超过5度（年龄68.8±8.6岁），对其进行三维（3D）计算机断层扫描，并生成跟骨和距骨的3D表面模型。分别在跟骨和距骨表面放置总共556个和430个地标点，以计算形状变异的主成分（PCs）。比较个体内HVA小的一侧和大的一侧的PC得分。
与HVA小的患者（平均33.7度）相比，HVA大的患者（平均43.2度）的跟骨具有细长的跟骨结节，在冠状面后关节面更向内侧，前中关节面更窄且更凹陷。与HVA小的相比，HVA大的距骨在横平面上距骨头更向内侧，距骨头外侧区域更向前突出。
HVA大患者的跟骨形态模式使后足骨易于向外翻方向旋转，而距骨的形态模式可导致第一跖骨更大的内旋。跟骨和距骨的这些形态模式可能是影响拇外翻的结构因素。
