Stokes I A, Hutton W C, Stott J R, Lowe L W
Clin Orthop Relat Res. 1979 Jul-Aug(142):64-72.
Abnormalities in the hallux valgus foot and changes after surgery were investigated by measuring the distribuiion of load on the foot in walking. Hallux valgus was associated with reduced load imposed on the toes, and on the medial side of the forefoot, compared with a large sample of healthy feet. Abnormalities correlated with the degree of the deformity. Both Keller's operation and a wedge displacement osteotomy of the first metatarsal not only failed to restore normal loading but increased the abnormalities of loading seen preoperatively. A large decrease in the angle between first and second metatarsals as a result of surgery minimized this increase. A silastic arthroplasty did not carry high loads when used to treat hallux valgus, but near normal loads were imposed on it when used for hallux rigidus. Considerable variability was found in the loading distribution on the healthy feet. The distribution between first and second metatarsal heads was partially dependent upon their protrusions, relative to the direction of walking. The changes in the relationships between the loadings on the forefoot and skeletal shape in response to surgical operations are important for our understanding of treatment of the hallux valgus foot.
通过测量行走时足部的负荷分布，研究了拇外翻足的异常情况及手术后的变化。与大量健康足部样本相比，拇外翻与施加在脚趾及前足内侧的负荷减少有关。异常情况与畸形程度相关。凯勒手术和第一跖骨楔形移位截骨术不仅未能恢复正常负荷，反而增加了术前可见的负荷异常。手术导致第一和第二跖骨之间的角度大幅减小，从而将这种增加降至最低。硅橡胶关节成形术用于治疗拇外翻时承受的负荷不高，但用于治疗僵硬性拇趾时施加在其上的负荷接近正常。在健康足部的负荷分布中发现了相当大的变异性。第一和第二跖骨头之间的分布部分取决于它们相对于行走方向的突出程度。前足负荷与骨骼形状之间关系在手术操作后的变化，对于我们理解拇外翻足的治疗具有重要意义。
