Mall G, Koebke J
Institut II für Anatomie, Universität Köln.
Sportverletz Sportschaden. 1993 Jun;7(2):73-7. doi: 10.1055/s-2007-993486.
One of the most important pathogenetic mechanisms regarding stress fractures of the navicular bone lies in the hyperpronation movement of the foot. For recording the impacts of the pronation movement on the talonavicular joint, stress and pressure experiments are carried out and the radii of curvature as well as the bone density are measured. The stress experiments show a rotation movement of the talar head in a medioplantar direction of about 20 degrees. The radii of curvature of the articulating joint surfaces do not differ to a great extent. A possible incongruency in the joint therefore has to be attributed to the rotation movement of the talus during pronation of the foot. The pressure experiments show a very irregular distribution of pressure in the joint presenting a lateral and medial pressure maximum. Fractures preferably occur in the area in between these maxima. Areas of high subchondral bone density in the densitometric results are found in the central part of the talar head as well as in the medial part of the navicular bone. Within the functional adaptation the distribution of bone density expresses the rotation movement of the talus during pronation of the foot.
舟骨应力性骨折最重要的发病机制之一在于足部的过度旋前运动。为记录旋前运动对距舟关节的影响，进行了应力和压力实验，并测量了曲率半径以及骨密度。应力实验显示距骨头向跖内侧方向有大约20度的旋转运动。关节面的曲率半径在很大程度上并无差异。因此，关节中可能存在的不协调必须归因于足部旋前时距骨的旋转运动。压力实验显示关节内压力分布非常不规则，呈现出外侧和内侧压力最大值。骨折最好发于这些最大值之间的区域。骨密度测量结果显示，在距骨头中央部分以及舟骨内侧部分发现软骨下骨密度较高的区域。在功能适应过程中，骨密度分布体现了足部旋前时距骨的旋转运动。
