Dyal C M, Feder J, Deland J T, Thompson F M
Albert Einstein College of Medicine, Bronx, NY, USA.
Foot Ankle Int. 1997 Feb;18(2):85-8. doi: 10.1177/107110079701800208.
Bilateral weightbearing anteroposterior and lateral radiographs were analyzed in 43 patients with a clinical diagnosis of posterior tibial tendon insufficiency by two independent observers. The radiographs of each patient's asymptomatic foot was considered to serve as the control for the preexistance of pes planus. The radiographs were assessed for the severity of flatfoot deformity, the degree of talonavicular coverage, the talometatarsal angle, the calcaneometatarsal angle, the cuneiform to ground height and the cuneiform to fifth metatarsal height. Interobserver correlations were assessed. Results indicated that there was a high interobserver correlation for the values measured, making these angles reproducible among observers. Strong correlations were found in the degree of severity of flatfoot deformity between the asymptomatic and symptomatic feet as well as the values used to assess pes planus (i.e., similar radiographic measurements on the opposite side). The data suggest that patients with posterior tibial tendon insufficiency often have a preexisting flatfoot. This substantiates our belief that a preexisting flexible flatfoot, although far from the determining factor, is one of several etiological factors in the development of posterior tibial tendon insufficiency.
由两名独立观察者对43例临床诊断为胫后肌腱功能不全的患者进行双侧负重前后位和侧位X线片分析。将每位患者无症状足的X线片视为扁平足预先存在情况的对照。对X线片进行扁平足畸形严重程度、距舟覆盖程度、距骨-跖骨角、跟骨-跖骨角、楔骨至地面高度以及楔骨至第五跖骨高度的评估。评估观察者间的相关性。结果表明，所测量值的观察者间相关性较高，使得这些角度在观察者之间具有可重复性。在无症状足和有症状足之间扁平足畸形严重程度以及用于评估扁平足的值（即对侧类似的X线测量）之间发现了强相关性。数据表明，胫后肌腱功能不全的患者通常预先存在扁平足。这证实了我们的观点，即预先存在的柔韧性扁平足虽然远非决定性因素，但却是胫后肌腱功能不全发生发展的几个病因之一。
