CAJ | 학술논문

目的测量对比成年人获得性平足与正常足二者差异和分析各指标,为诊断和修复重建手术提供参考依据.方法 2008年1月至2014年5月,对成都军区总医院骨科成年人获得性平足患者85例85足和90名正常人90足进行比较分析,分别对患者组术前和正常组足摄站立位正侧位X线片,比较两组内侧柱长度(MCL)、外侧柱长度(LCL)、内侧纵弓高度(MCH)、外侧纵弓高度(LCH)、距舟关节未包容角(TNUA)、距骨-第一跖角度(TMTA)、跟骨倾斜角(CPA),对年龄和各测量指标进行Logistic回归分析.结果在正位X线片上,患者组与正常组的MCL分别为(103.5 ±9.0)mm和(105.8 ±7.8)mm,LCL分别为(94.6 ±6.9) mm和(96.2 ±6.1)mm,组间差异均无统计学意义(均P ＞0.05);TMTA分别为(18.9±2.5)°和(7.8±2.2)°、TNUA分别为(23.6±3.2)°和(8.0±2.2)°,差异均有统计学意义(均P＜0.01).在侧位X线片上,患者组与正常组MCH分别为(16.3±1.7)mm和(23.6 ±2.8)mm,LCH分别为(14.9±1.1)mm和(14.0±1.4) mm,CPA分别为(14.9±2.8)°和(22.9±1.9)°、TMTA分别为(10.0±2.0)°和(-3.6±1.0)°,差异均有统计学意义(均P＜0.0l).Logistic回归分析显示,各指标重要性依次为侧位TMTA (B =0.032)、正位TNUA(B=0.014)、正位TMTA(B=0.015)、侧位MCH(B=-0.012)、侧位CPA(B=-0.009).结论成年人获得性平足患者相对于正常人群MCL、LCL无差异,侧位TMTA、正位TNUA、正位TMTA呈正相关,侧位MCH和侧位CPA呈负相关,侧位TMTA是诊断和手术评估治疗方案的优选指标.
목적 측량대비성년인획득성평족여정상족이자차이화분석각지표,위진단화수복중건수술제공삼고의거.방법 2008년1월지2014년5월,대성도군구총의원골과성년인획득성평족환자85례85족화90명정상인90족진행비교분석,분별대환자조술전화정상조족섭참립위정측위X선편,비교량조내측주장도(MCL)、외측주장도(LCL)、내측종궁고도(MCH)、외측종궁고도(LCH)、거주관절미포용각(TNUA)、거골-제일척각도(TMTA)、근골경사각(CPA),대년령화각측량지표진행Logistic회귀분석.결과 재정위X선편상,환자조여정상조적MCL분별위(103.5 ±9.0)mm화(105.8 ±7.8)mm,LCL분별위(94.6 ±6.9) mm화(96.2 ±6.1)mm,조간차이균무통계학의의(균P ＞0.05);TMTA분별위(18.9±2.5)°화(7.8±2.2)°、TNUA분별위(23.6±3.2)°화(8.0±2.2)°,차이균유통계학의의(균P＜0.01).재측위X선편상,환자조여정상조MCH분별위(16.3±1.7)mm화(23.6 ±2.8)mm,LCH분별위(14.9±1.1)mm화(14.0±1.4) mm,CPA분별위(14.9±2.8)°화(22.9±1.9)°、TMTA분별위(10.0±2.0)°화(-3.6±1.0)°,차이균유통계학의의(균P＜0.0l).Logistic회귀분석현시,각지표중요성의차위측위TMTA (B =0.032)、정위TNUA(B=0.014)、정위TMTA(B=0.015)、측위MCH(B=-0.012)、측위CPA(B=-0.009).결론 성년인획득성평족환자상대우정상인군MCL、LCL무차이,측위TMTA、정위TNUA、정위TMTA정정상관,측위MCH화측위CPA정부상관,측위TMTA시진단화수술평고치료방안적우선지표.
Objective To evaluate and compare the radiographic parameters between patients of adult acquired flatfoot and normal participants to provide rationales for diagnosis and operative reconstruction.Methods The adult acquired deformity group consisted of 85 patients (85 feet) and normal group 90 normal participants (90 feet) from January 2008 to May 2014.The weight-bearing anteroposterior and lateral foot radiographs were taken.And the following parameters were measured and compared:medial column length (MCL),lateral column length (LCL),medial column height (MCH),lateral column height (LCH),talonavicular uncoverage angle (TNUA),talus-first metatarsal angle (TMTA) and calcaneal pitch angle (CPA).Age and all parameters were included for Logistic regression analysis.Results On anteroposterior radiographs,the values of MCL for adult acquired deformity and normal groups were (103.5 ± 9.0),(105.8 ± 7.8) mm and LCL (94.6 ± 6.9),(96.2 ± 6.1) mm respectively.No significant difference existed in MCL or LCL (P ＞ 0.05).However,significant inter-group differences existed in TMTA and TNUA (P ＜ 0.01).The values of TMTA were (18.9 ± 2.5)°,(7.8 ± 2.2) ° and TNUA (23.6 ± 3.2) °,(8.0 ± 2.2) °.On lateral radiographs,significant inter-group differences existed in MCH,LCH,CPA and TMTA (P ＜ 0.01).And the values of MCH were (16.3 ± 1.7),(23.6 ± 2.8) mm,LCH (14.9 ± 1.1),(13.96±l.39)mm,CPA (14.86±2.76)°,(22.9±1.9)° andTMTA (10.0±2.0)°,(-3.6± 1.0) ° respectively.According to Logistic regression analysis,the significance of parameters ranged from lateral TMTA (B =0.032),anteroposterior TNUA (B =0.014),anteroposterior TMTA (B =0.015) to lateral MCH (B =-0.012),lateral CPA B (B =-0.009).Conclusion No differences exist in anteroposterior MCL or LCL.There are positive differences in lateral TMTA,anteroposterior TNUA and anteroposterior TMTA.And negative differences exist in lateral MCH and lateral CPA between adult flatfoot and normal foot.Lateral TMTA may be an excellent radiographic identifier of patients with adult acquired flatfoot during diagnosis and treatment.