微创截骨治疗小趾囊炎足底压力研究
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中国中医科学院望京医院

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北京自然科学基金项目(7162205)


The study of plantar pressure with Tailor’s bunion in minimally invasive osteotomy
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Wangjing Hospital, China Academy of Chinese Medical Sciences

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    摘要:

    摘要:[目的]研究微创截骨技术治疗小趾囊炎足底压力变化。[方法]回顾性分析2017年4月~2018年9月本院行微创截骨手术治疗小趾囊炎患者37例71足,33例66足正常者纳入本研究。采用footscan足底压力测试系统对患者及正常人前足第1跖骨至第5跖骨(M1-M5)动态峰值压力(PF)、压强(PP)和冲量(PI)指标进行测量和分析,研究小趾囊炎足底生物力学特性。[结果]患者术前M1-M5动态PF、PP和PF值明显高于正常人组(P<0.05)。平均随访时间(14.13±2.02)个月。患者M1手术前后PF、PP、PI指标之间的差异无统计学意义(P>0.05),术后M2-M5跖骨的PF、PP、PI值明显低于术前(P<0.05)。患者术后与正常人(PF、PP、PI)指标的差异无统计学意义(P>0.05)。患者术前动态PF、PP、PI各测量值分布均为M5、M3、M2、M4、M1依次递减。患者术后及正常人动态PF、PP、PI各测量值分布均为M2、M3、M1、M4、M5依次递减。患者的体重、身高、鞋号与第5跖骨动态力学测量值的差异无统计学意义(P>0.05),患者的年龄与第5跖骨峰值压强呈正相关。[结论]小趾囊炎导致前足第5跖骨负重增加,前足运动轨迹外移。微创截骨技术可有效矫正小趾内翻畸形,恢复前足正常负重。足底动态力学测量可以较准确的反应小趾囊炎足底负重的变化,对于临床疗效的评价可靠。

    Abstract:

    Abstract: [Objective] To study the change of plantar pressure of tailor’s bunion with minimally invasive osteotomy.[Methods] A retrospective analysis was conducted on tailor’s bunion of 37 patients(71 feet)who underwent minimally invasive osteotomy in our hospital from April 2017 to September 2018 and 33 normal subjects(66 feet)were included in this study.The footscan plantar pressure test system was used to measure and analyze the peak force(PF), peak pressure(PP) and peak impulse (PI) which were indicators of patients and subjects from the feet 1st to 5th metatarsal head (M1~M5) and investigated the biomechanical characteristics of tailor’s bunion.[Results]These preoperative dynamic values of PF, PP, and PF were significantly higher than the normal group in M1~M5(P<0.05).The average follow-up time was (14.13±2.02) months. There were no statistically significant differences in PF, PP, and PI of the M1 with tailor’s bunion of patients of before and after surgery (P> 0.05). These postoperative dynamic values of PF, PP, and PF were significantly lower than the preoperative group in M2~M5(P<0.05).There were no significant difference in PF,PP and PI from M1-M5 between the postoperative indicators of patients and the subjects(P>0.05). The preoperative values of PF, PP, and PI were descending orders from M5、M3、M2、M4 to M1. The subjects and postoperative measured values of PF, PP, and PI were descending orders from M2, M3, M1, M4 to M5.There were no statistically significant difference in the weight, height, shoe size, and dynamic measurement of the 5th metatarsal plantar foot (P>0.05),it was a positive correlation between the patient's age and the peak of dynamic pressure.[Conclusion]The tailor’s bunion leads to increase metatarsal head (M5) in weight and move out in trajectory of forefoot.Minimally invasive osteotomy showed that the treatment method can correct a effectively varus deformity in little toe and the resumption of normal weight-bearing foot.The plantar dynamic mechanical measurements can be accurate response to the tailor’s bunion of changes in weight and a reliable assessment of clinical efficacy.

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  • 收稿日期:2020-03-16
  • 最后修改日期:2020-07-30
  • 录用日期:2020-09-03
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