拇趾跖籽关节炎与拇外翻畸形程度的相关性研究

目的:探讨拇外翻患者拇趾跖籽关节炎严重程度与拇外翻畸形程度的关系。方法:观察在中国中医科学院望京医院骨关节二科2007年1月～2009年5月期间治疗的162例(302足)拇外翻患者X线及临床检查,采用温建民等提出的分型标准进行拇外翻畸形分度,采用改良美国风湿病学会1995年的诊断标准制定跖籽关节炎的临床诊断标准,采用以Kellgren&Lawrence分级标准为基础的跖籽关节炎分度自拟标准,根据专家分别评价汇总结果判定法来分别确定拇外翻患者跖籽关节炎程度及拇外翻畸形程度,运用相关的统计学方法,对二者相关性进行分析。结果:轻度拇外翻患者中:23.94%无跖籽关节炎,轻度跖籽关节炎占25.35%,中度跖籽关节炎占36.62%,重度跖籽关节炎占14.08%;在中度拇外翻患者中:15.44%无跖籽关节炎,轻度跖籽关节炎占23.49%,中度跖籽关节炎占49.00%,重度跖籽关节炎占12.08%;在重度拇外翻患者中:7.32%无跖籽关节炎,轻度跖籽关节炎占25.61%,中度跖籽关节炎占37.08%,重度跖籽关节炎占29.27%。经Kendall等级相关检验,轻、中、重度拇外翻与跖籽关节炎严重程度无明显相关性(P>0.05)。结论:拇外翻患者跖籽关节炎严重程度与拇外翻畸形程度无明显相关性,但中度拇外翻患者中跖籽关节炎所占比重明显增加。

Correlation of the Degrees of Hallux Plantar Arthritis and Hallux Valgus Deformity

Objective：To detect the correlation between the degrees of hallux plantar arthritis and hallux valgus deformity. Methods：All 162 cases （302 foot） of hallux valgus deformity were observed by X-ray and clinical examination form January 2007 to May 2009 in our hospital. The degrees of hallux valgus deformity were graded by Wen Jianming proposed classifi- cation criteria. The hallux plantar arthritis was diagnosed by improved criteria of the American College of Rheumatology in 1995, and the degrees of the arthritis were graded by the standards of Kellgren ＆ Lawrence. Then collected and analyzed the correlation between the degrees of hallux plantar arthritis and hallux valgus deformity which were evaluated by the ex perts. Results：In patients of mild hallux valgus, 23.94% without hallux plantar arthritis, 25.35 % with mild hallux planlar arthritis, 36.62 % with moderate hallux plantar arthritis, and 14.08 % with severe hallux plantar arthritis. These were 15. 44%, 23.49%, 49.00%, and 12.08% in the patients of moderate hallux valgus respectively, and 7.32%, 25.61%, 37. 08%, and 29.27% in the patients of severe hallux valgus respectively. There was no significant correlation between mild, moderate, and severe degree of hallux vaIgus deformity and degree of hallux plantar arthritis （P〉0.05）. Conclusion： There is no correlation between degrees of hallux valgus deformity and degrees of hallux plantar arthritis, but the proportion of hallux plantar arthritis is increased in moderate degrees of hallux valgus deformity.