第1跖趾关节融合术后前足评分与足底压力的分析

[目的]分析第1跖趾关节融合术后对前足功能影响,以及对推进期足底压力的影响.[方法]15例患者共18足,行第1跖趾关节融合术后2年以上,根据AOFAS评分系统,对第1跖趾关节功能评分,并与正常对照组进行足底压力测试.测量前足底推进期的(足母)趾下、第1～5跖骨下共6处的峰值压强、峰值压力、压强-时间积、压力-时间积四个参数.[结果]融合术后AOFAS第1跖趾关节评分满意,术后组的(足母)趾下四项参数均明显小于正常人组.与时间相关的参数在(足母)趾下,以及第2、4、5跖骨头下小于正常人组,并具有明显差异.第1跖骨头下的峰值压强与峰值压力与对照组没有统计学差异.[结论]第1跖趾关节融合术后患者在推进期,前足跖骨头的足底压力分布与正常人基本相同.术后前足功能改善.术后(足母)趾下压力减少,但是对前足压力分布没有影响.

Forefoot function and pressure distribution after first metatarsophalangeal arthrodesis

[Objective]This study analyzed the forefoot function and forefoot pressure alterations in push-off phase after first metatarsophalangeal joint arthrodesis.[Methods]15 patients,18 feet,successfully finished 2 years follow-up after first metatarsophalangeal arthrodesis.All patients were analyzed with AOFAS score of first metatarsalphalangeal joint,and compared forefoot pressure with a normal control group.Recorded data included peak pressure,peak force,pressure-time product,force-time product.Six regions under forefoot were measured,under the hallux and first to fifth metatarsal heads.[Results]After the first MTP joint arthrodesis,AOFAS score were satisying.All parameters under hallux region were significantly smaller than those in control group.Two parameters related to time were smaller under hallux and 2,4,5 metatarsal heads in postoperative patients.Peak pressure and peak force were larger under patients’ first metatarsal heads,but without significance statistically.[Conclusion]First MTP joint arthrodesis does not affect the pressure distribution of forefoot in push-off phase.It improves the affected forefoot function.Weight-bearing under hallux is reduced,but forefoot pressure distribution is not affected.