Daniels T R, Smith J W, Ross T I
Emory University School of Medicine, Atlanta, Georgia 30303, USA.
J Bone Joint Surg Am. 1996 Oct;78(10):1559-67. doi: 10.2106/00004623-199610000-00015.
We performed an in vitro study on twelve specimens of the foot and ankle from cadavera to determine whether varus malalignment of the talar neck alters the position of the foot and subtalar motion. An osteotomy of the talar neck was performed, and the specimens were studied with and without removal of a medially based wedge of bone. Removal of the wedge produced an average varus malalignment of the talar neck of 17.1 +/- 2.4 degrees (range, 12.5 to 21.0 degrees). In the coronal plane, the average arc of motion of the subtalar joint decreased from 17.2 +/- 3.3 degrees before the osteotomy to 11.7 +/- 2.9 degrees after the osteotomy and removal of the wedge. In the transverse plane, it decreased from 17.5 +/- 2.9 degrees to 11.9 +/- 2.4 degrees. In the sagittal plane, it decreased from 8.9 +/- 2.4 degrees to 6.8 +/- 2.3 degrees. The decrease in subtalar motion was characterized by an inability to evert the foot; inversion was not limited, however. The malalignment produced an average of 4.8 +/- 1.2 degrees of varus deformity and 8.7 +/- 2.3 degrees of internal rotation of the hindfoot and an average of 5.5 +/- 2.0 degrees of varus deformity and 11.5 +/- 2.4 degrees of adduction of the forefoot. A linear correlation analysis was used to compare the change in subtalar motion and the position of the foot with the degree of varus malalignment at the talar neck. The correlation coefficient was 0.90 (p < 0.01) for subtalar motion, 0.76 (p < 0.01) for internal rotation of the calcaneus, and 0.81 (p < 0.01) for adduction of the forefoot. This indicated a direct correlation between the degree of varus malalignment at the talar neck and the change in the position of the foot and in subtalar motion.
我们对取自尸体的12个足踝标本进行了一项体外研究，以确定距骨颈内翻畸形是否会改变足部位置和距下关节运动。我们对距骨颈进行了截骨术，并在去除和未去除内侧楔形骨块的情况下对标本进行了研究。去除楔形骨块后，距骨颈平均内翻畸形为17.1±2.4度（范围为12.5至21.0度）。在冠状面上，距下关节的平均运动弧度从截骨术前的17.2±3.3度降至截骨并去除楔形骨块后的11.7±2.9度。在横断面上，从17.5±2.9度降至11.9±2.4度。在矢状面上，从8.9±2.4度降至6.8±2.3度。距下关节运动的减少表现为足部无法外翻；然而，内翻不受限制。这种畸形导致后足平均内翻畸形4.8±1.2度和内旋8.7±2.3度，前足平均内翻畸形5.5±2.0度和内收11.5±2.4度。我们使用线性相关分析来比较距下关节运动和足部位置的变化与距骨颈内翻畸形的程度。距下关节运动的相关系数为0.90（p<0.01），跟骨内旋的相关系数为0.76（p<0.01），前足内收的相关系数为0.81（p<0.01）。这表明距骨颈内翻畸形程度与足部位置变化和距下关节运动之间存在直接相关性。
