Kitaoka H B, Luo Z P, An K N
Department of Orthopedics, Mayo Clinic, Rochester, MN 55905, USA.
Am J Sports Med. 1997 Mar-Apr;25(2):238-42. doi: 10.1177/036354659702500218.
We defined foot and ankle motion with respect to the neutral position. Thirteen normal fresh-frozen specimens of the human foot were used. The foot was placed in the extreme positions of pronation, supination, dorsiflexion, and plantar flexion, and positions of multiple bones were monitored simultaneously with a magnetic tracking device to determine rotation of the talocrural, subtalar, metatarsal-navicular, and talonavicular joints under the various conditions. In pronation, the most rotation occurred at the metatarsal-navicular level, followed by the navicular-talar, talar-tibial, and calcaneal-talar levels. In supination, most rotation occurred at the navicular-talar level, followed by the calcaneal-talar, talar-tibial, and metatarsal-navicular levels. In dorsiflexion, most rotation occurred at the talar-tibial level, followed by the navicular-talar, calcaneal-talar, and metatarsal-navicular levels. In plantar flexion, most rotation occurred at the talar-tibial level, but there was considerable motion at the navicular-talar, metatarsal-navicular, and calcaneal-talar levels. Understanding the specific joint motions that occur with various positions of the foot and ankle is important because measurements of joint mobility may assist in establishing diagnoses, monitoring clinical conditions, determining indications for operative treatment, assessing results of treatment, and following the progress of rehabilitation.
我们根据中立位来定义足踝关节的运动。使用了13个正常的人体新鲜冷冻足部标本。将足部置于旋前、旋后、背屈和跖屈的极端位置，并用磁跟踪装置同时监测多块骨骼的位置，以确定在各种情况下距小腿关节、距下关节、跖舟关节和距舟关节的旋转情况。在旋前时，最大旋转发生在跖舟关节水平，其次是舟距关节、距胫关节和跟距关节水平。在旋后时，最大旋转发生在舟距关节水平，其次是跟距关节、距胫关节和跖舟关节水平。在背屈时，最大旋转发生在距胫关节水平，其次是舟距关节、跟距关节和跖舟关节水平。在跖屈时，最大旋转发生在距胫关节水平，但在舟距关节、跖舟关节和跟距关节水平也有相当大的运动。了解足踝关节不同位置时发生的特定关节运动很重要，因为关节活动度的测量有助于确立诊断、监测临床状况、确定手术治疗指征、评估治疗效果以及跟踪康复进程。
