Alvarez R, Haddad R J, Gould N, Trevino S
Foot Ankle. 1984 Mar-Apr;4(5):229-40. doi: 10.1177/107110078400400502.
The pathomechanics for the development of the hallux valgus deformity takes place at the first metatarsophalangeal joint--the sesamoid complex. The sesamoid complex consists of seven muscles, eight ligaments, and two sesamoid bones. When the first metatarsal escapes the complex and drifts medially, the sesamoids remain twisted in situ, several of the ligaments "fail," and others contract. The authors propose reduction of the metatarsus primus varus by first metatarsal osteotomy and appropriate ligament releases and plications to restore alignment. A detailed understanding of the pathomechanics is essential for proper interpretation of the problems and anticipated lasting surgeries.
拇外翻畸形发展的病理力学发生在第一跖趾关节——籽骨复合体处。籽骨复合体由七块肌肉、八条韧带和两块籽骨组成。当第一跖骨脱离该复合体并向内侧移位时，籽骨仍原地扭转，数条韧带“失效”，其他韧带则收缩。作者建议通过第一跖骨截骨术以及适当的韧带松解和折叠术来矫正第一跖骨内翻，以恢复对线。对病理力学的详细了解对于正确解读问题和预期持久的手术效果至关重要。
