Aseyo D, Nathan H
Int Orthop. 1984;8(1):67-73. doi: 10.1007/BF00267743.
The normal characteristics of the hallux sesamoid bones were studied in 200 toes (100 dissections and 100 radiographs from patients with hallux valgus), and pathological changes were recorded. Normally each sesamoid articulated with a separate groove on the plantar surface of the first metatarsal head. A bony ridge on the head separated these grooves. Bipartite sesamoids were found in 4% of the toes. Osteoarthritic changes manifested by deformity, irregularity, lipping, cysts in the sesamoids and in the heads of the first metatarsal, and erosions in the articular surfaces were present in 32% of the dissected toes. Fusion of the sesamoids was found in 6%. Ankylosis between the sesamoids and the head of the metatarsal was observed in 4%. In the toes affected by hallux valgus the sesamoids, together with the plantar pad and the tendon of the flexor hallucis brevis, were displaced laterally to a variable degree. In severe deformities the lateral sesamoid was dislocated lateral to the first metatarsal head and the medial sesamoid occupied the groove originally corresponding to the lateral sesamoid, while the metatarsal ridge separating the two sesamoids tended to disappear. Osteoarthritis of the metatarsophalangeal joint frequently accompanied hallux valgus.
对200个拇趾（100例解剖标本和100例拇外翻患者的X线片）的拇籽骨正常特征进行了研究，并记录了病理变化。正常情况下，每个籽骨与第一跖骨头跖面的一个独立凹槽相关节。跖骨头上的骨嵴将这些凹槽分开。在4%的拇趾中发现了二分籽骨。在32%的解剖拇趾中存在骨关节炎改变，表现为籽骨及第一跖骨头的畸形、不规则、唇样骨质增生、囊肿以及关节面侵蚀。6%的拇趾出现籽骨融合。4%的拇趾观察到籽骨与跖骨头之间的关节强硬。在拇外翻累及的拇趾中，籽骨连同跖垫和拇短屈肌腱不同程度地向外侧移位。在严重畸形中，外侧籽骨向第一跖骨头外侧脱位，内侧籽骨占据原本对应外侧籽骨的凹槽，而分隔两个籽骨的跖骨嵴往往消失。跖趾关节骨关节炎常伴有拇外翻。
