跖腱膜炎与足弓影像学相关因素分析

发布时间：2018-05-02 10:10

本文选题：跖腱膜炎 + 足弓　；参考：《北京中医药大学》2012年硕士论文

【摘要】：目的：通过观察跖腱膜炎足与对照组的负重与非负重内外侧足纵弓角度,探讨跖腱膜炎足骨性足纵弓形态学分布规律特点,病理变化及其代表的临床意义。方法：收集资料,包括跖腱膜炎患者27例32足(合并有跟下脂肪垫炎5例6足),其中男11例15足,女16例17足,左足17例,右足15例；年龄38～70岁,平均57岁：病程2月～2年,平均7月。无足部疾病患者21例30足,其中男7例10足,女14例20足,左足15足,右足15足：年龄30～65岁,平均51岁。分别对32例跖腱膜炎足及30例对照组拍摄足侧位X线片及负重侧位X线片,分别测量内弓顶角、外弓顶角,并通过计算分别得出跖腱膜炎足与对照组内弓顶角和外弓顶角在负重位与非负重位纵弓顶角的差值。比较跖腱膜炎足与对照组之间的差异,分别分析非负重位和负重位,跖腱膜炎足和对照组代表内侧足弓的内弓顶角、代表外侧足弓的外弓顶角的统计学意义及其变化特点,并借助结构力学方法加以验证。结果：27例试验组体重为74.2±12.3kg,体重中值为70kg。21例对照组中,体重为64.0±9.3kg,中值为60kg。27例试验组中,BMI值为26.7±3.5,中值为26.3；21例受试者中BMI值为24.0±2.1,中值为24.0。在非负重位中,试验组内弓顶角为114.4°±7.3°,中值为114.5°,对照组为113.6°±4.9°,中值为114°；前者外弓顶角为135.9±9.1°,中值为134°,对照组为134.1°±5.1°,中值为132.5°；在负重位中,试验组内弓顶角为128.9°±7.5°,中值为128.5°,对照组为129.3°±5.2°,中值为130°；前者外弓顶角为144.8°±9.4°,中值为145°,对照组为146.3°±5.5°,中值为148°。试验组从非负重位时至负重位时,内弓顶角改变值为14.6°±5.1°,中值为15.0°,对照组为15.7°±5.3°,中值为14.5°；外弓顶角改变值前者为8.9°±5.3°,中值为8.5°,对照组为12.2°±4.8°,中值为11°。试验组与对照组在非负重位与负重位时内外侧足纵弓形态无明显差异(P0.05)；负重后二者的内侧足纵弓改变较负重前无显著差异(P0.05),而外侧足纵弓改变较负重前差异显著(P0.05)。结论：1.超重是引起跖腱膜炎的原因之一；2.跖腱膜炎患者中在静力条件下足弓形态往往与对照组无明显差异；3.引起跖腱膜炎的本质原因不在于静态下纵弓的外形而在于负重后纵弓能不能通过足够的形变以吸收应力,站立时足部不能充分的通过外侧纵弓形变吸收应力,这可能是引起跖腱膜炎的另一个原因。
[Abstract]:Objective: To investigate the morphological distribution of the longitudinal arch of the foot of the foot of the plantaris aponeurotis and the clinical significance of the pathological changes and its clinical significance by observing the weight negative and non weight-bearing lateral foot longitudinal arch of the plantaris aponeurotis and the control group. Methods: collecting data, including 27 cases of plantar aponeurotis with 32 feet (with 5 cases of 6 feet with subheel fat cushion). There were 11 men with 15 feet, 16 women with 17 feet, 17 left feet and 15 right feet, 38~70 years old, with an average of 57 years, average July. 21 patients without foot disease were 30 feet, including 7 10, left foot, left foot, right foot, foot and right foot. The difference between the top angle of the metatarsal aponeurosis and the top angle of the external arch in the control group was compared with the control group. The difference between the plantar aponeurosis foot and the control group was compared, and the non weight negative and weight negative positions were analyzed, and the plantaris aponeurosis and the foot were analyzed. The control group represented the internal arch top angle of the medial arch, representing the statistical significance of the outer arch top angle of the lateral arch and the characteristics of its change, and verified by the structural mechanics method. Results: the weight of the 27 cases was 74.2 + 12.3kg, the median weight was 64 + 9.3kg in the control group and the median was 60kg.27 test group, and the BMI value was 2. The median is 6.7 + 3.5 and the median is 26.3. The BMI value of the 21 subjects is 24 + 2.1, the median is 24.0. in the non negative weight position, the arch top angle of the test group is 114.4? 7.3 degrees, the median is 113.6 [21], the median is 114 [degree]; the former is 135.9 + 0 degrees, the middle value is [degree], the middle value is deg. In the test group, the arch top angle in the test group is 128.9 + 7.5 degrees, the median is 128.5 degrees, the control group is 129.3 + 5.2 degrees, the median is 130 degrees, the former is 144.8? 9.4 degrees, the median is 145 degrees, the control group is 146.3 [129.3], and the median is 148 degree. The control group was 15.7 + 5.3 degrees, the median value was 14.5 degrees, the change of the top angle of the external arch was 8.9 + 5.3 degrees, the median was 8.5 degrees, the control group was 12.2? 4.8 degrees, and the median was 11 degrees. There was no significant difference between the experimental group and the control group in the shape of the medial and lateral foot longitudinal arch at the non negative weight position and the negative weight position (P0.05); the change of the medial foot longitudinal arch after the negative weight was not obvious before the negative weight. The difference (P0.05) was significant (P0.05) in the lateral foot longitudinal arch (P0.05). Conclusion: 1. overweight is one of the causes of the plantaris aponeurotis. The morphology of the arch in the static condition is often not significantly different from the control group. 3. the root cause of the plantaris aponeurotis is not the shape of the static lower longitudinal arch. The posterior longitudinal arch can not be subjected to sufficient deformation to absorb stress. The foot can not fully absorb stress through the lateral longitudinal arch when standing, which may be another cause of the plantaris aponeurotis.

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.8

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