Bu Pengfei, Li Chuan, Pu Luqiao, Ma Xinyu, Meng Xuhan, Xu Yongqing
Department of Orthopaedic, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, Yunnan, P.R. China.
Department of Anesthesiology, 920th Hospital of Joint Logistics Support Force, PLA, Kunming, Yunnan, P.R. China.
J Foot Ankle Surg. 2023 May-Jun;62(3):583-589. doi: 10.1053/j.jfas.2022.06.009. Epub 2022 Jun 28.
The research results are inconsistent that assessing whether the increased obliquity of the distal articular surface of the medial cuneiform leads to an increase in hallux valgus angle. Thus, this study investigated the relationship between distal medial cuneiform obliquity and hallux valgus by measuring various angles in weightbearing anteroposterior radiographs of the foot. In total, 679 feet of 538 patients with the radiographs were included in the study. We measured radiographic parameters including hallux valgus angle, first to second intermetatarsal angle, metatarsus adductus angle, first metatarsus cuneiform angle, distal medial cuneiform angle, and first proximal metatarsal articular angle. The surface morphology (flat or curved) of the first tarsometatarsal joint was also recorded. Our results analysis revealed a weak negative correlation between distal medial cuneiform angle and both hallux valgus angle and first to second intermetatarsal angle, contrary to our assumption. So we believe that distal medial cuneiform angle was relatively constant and it cannot be used as a characteristic angle for quantifying hallux valgus. First metatarsus cuneiform angle was a characteristic indicator of hallux valgus and was positively correlated with its severity (p < .000), indicating that it can be used to measure the size of hallux valgus. It can also be used as a reference factor for the first metatarsal osteotomy in clinical bunion orthopedics. First tarsometatarsal joint morphology was unrelated to hallux valgus, whereas metatarsus adductus angle, and first proximal metatarsal articular angle should be considered in hallux valgus.
关于评估内侧楔骨远端关节面倾斜度增加是否会导致拇外翻角度增大，研究结果并不一致。因此，本研究通过测量足部负重前后位X线片上的各种角度，探讨了内侧楔骨远端倾斜度与拇外翻之间的关系。本研究共纳入了538例患者的679只脚的X线片。我们测量了包括拇外翻角度、第一与第二跖骨间角度、跖骨内收角、第一跖骨与楔骨角度、内侧楔骨远端角度以及第一跖骨近端关节角度等影像学参数。还记录了第一跖跗关节的表面形态（平坦或弯曲）。我们的结果分析显示，与我们的假设相反，内侧楔骨远端角度与拇外翻角度以及第一与第二跖骨间角度之间存在弱负相关。因此我们认为，内侧楔骨远端角度相对恒定，不能用作量化拇外翻的特征性角度。第一跖骨与楔骨角度是拇外翻的特征性指标，与拇外翻严重程度呈正相关（p <.000），表明它可用于测量拇外翻的大小。它还可作为临床拇囊炎矫形中第一跖骨截骨术的参考因素。第一跖跗关节形态与拇外翻无关，而在拇外翻中应考虑跖骨内收角和第一跖骨近端关节角度。
