Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan.
Foot Ankle Surg. 2023 Dec;29(8):621-626. doi: 10.1016/j.fas.2023.07.011. Epub 2023 Jul 25.
An association between the medial partite hallux sesamoid (MPHS) and hallux valgus (HV) has been suggested; however, a causal relationship has not been confirmed. This study aimed to determine their causal relationship using a cross-sectional radiographic survey of a large-scale population cohort covering a wide age group.
The fifth survey of the Research on Osteoarthritis/Osteoporosis against Disability study involved 1997 participants aged 21-95 years who had undergone anteroposterior radiography of bilateral feet. The presence of MPHS, its morphology, and radiographic parameters related to the HV were assessed using radiographs. Changes in the prevalence of MPHS with age were assessed using trend tests. The relationship between the MPHS and HV was assessed based on sex and age.
MPHS was found in 508 out of 3994 feet (12.7 %), with a significant difference in prevalence between men and women (10.0 % vs. 13.7 %, p < 0.001). Trend analysis demonstrated a significant decrease in MPHS occurrence with age in both sexes. HV angle was significantly higher in feet with MPHS than in those without (Men: 17.8 ± 7.0° vs. 14.0 ± 5.9°, p < 0.0001; Women: 19.6 ± 7.7° vs. 17.7 ± 7.9°, p < 0.0001). The prevalence of HV angle ≥ 20° was also significantly higher in feet with MPHS than in those without (Men: 33.3 % vs. 14.6 %, p < 0.0001; Women: 46.5 % vs. 34.6 %, p < 0.0001). This association between MPHS and HV was noticeable in younger adults and became less prominent with age.
MPHS is associated with HV. The weakening of this relationship and the decreased prevalence of MPHS with age suggest that MPHS is not caused by HV, but is one of the causes of HV, especially in younger adults.
有人认为内侧籽骨霍尔曼（MPHS）与足拇外翻（HV）之间存在关联；然而，其因果关系尚未得到证实。本研究旨在通过对涵盖广泛年龄组的大规模人群队列的横断面放射学调查来确定它们之间的因果关系。
研究骨关节炎/骨质疏松症对残疾的研究第五次调查涉及 1997 名年龄在 21-95 岁之间的参与者，他们接受了双侧足部的前后位放射摄影。使用 X 线片评估 MPHS 的存在、其形态以及与 HV 相关的放射学参数。使用趋势检验评估 MPHS 随年龄变化的患病率变化。根据性别和年龄评估 MPHS 与 HV 之间的关系。
在 3994 只脚中发现了 508 只（12.7%），男性和女性之间的患病率存在显著差异（10.0%对 13.7%，p<0.001）。趋势分析表明，两性的 MPHS 发生率均随年龄增长而显著降低。有 MPHS 的脚的 HV 角明显高于没有 MPHS 的脚（男性：17.8±7.0°对 14.0±5.9°，p<0.0001；女性：19.6±7.7°对 17.7±7.9°，p<0.0001）。有 MPHS 的脚的 HV 角≥20°的患病率也明显高于没有 MPHS 的脚（男性：33.3%对 14.6%，p<0.0001；女性：46.5%对 34.6%，p<0.0001）。这种 MPHS 与 HV 之间的关联在年轻成年人中较为明显，随年龄增长而变得不那么明显。
MPHS 与 HV 相关。这种关系的减弱以及 MPHS 患病率随年龄增长而降低表明，MPHS 不是由 HV 引起的，而是 HV 的原因之一，尤其是在年轻成年人中。
