站立負重X光影像對大腳趾外翻手術決策的影響

The Effect of Weight-bearing of Foot Radiographs on the Surgical Decisions of Hallux Valgus

黃文娟(Wen-Chuan Huang) ； 尤雅君(Ya-Chun Yo) ； 周怡君(Yi-Jiun Chou) ； 陳坤煌(Kuen-Huang Chen)

《中華放射線技術學雜誌》 32卷2期 (2008/12) Pp. 141-148

摘要

大腳趾外翻(Hallux Valgus)是常見足部疾病之一，但有利於大腳趾外翻的攝影方法卻較少被討論。過去一般常用來診斷足部疾病的足部攝影(anteroposterior projection of the foot; AP projection of the foot)是指未施加壓力於病人足部的拍攝方法，然而多數大腳趾外翻的病患常於站立負重時感覺疼痛不舒服，而未負重攝影卻無法呈現出病人站立時的真實狀態，因此我們利用足部前後位負重攝影(weight-bearing AP projection of the foot)與足部未負重攝影(non weight-bearing AP projection of the foot)的影像來比較其大腳趾外翻角度(Hallux valgus angle, HVA)及第一蹠骨間的角度(1(上標 st) intermetatarsal angle, IMA)的差異，進而提供外科手術的估評。在此研究中我們共收集40位不同程度的大腳趾外翻的病患，經統計後發現此40位病患足部負重攝影的HVA都大於未負重攝影，除了可提供外科醫生選擇合適的矯正術式外，更可提供醫生在手術中更精確的調整其HVA，術後經臨床追蹤確實大幅提高了手術的成功率。對於大腳趾外翻需要手術矯正的病人，足部前後位負重攝影除了可真實呈現出病人足部負重的真實狀態，在臨床診斷上有其正確性及可行性的幫助，並可提高手術的成功率及降低復發的可能性。

關鍵字

腳趾外翻 ； 足部前後位負重攝影 ； 大腳趾外翻角度 ； 蹠骨間的角度

並列摘要

Hallux Valgus is the one of the most common foot diseases, but the effective methods used to investigate into how the foot disease, Hallux Valgus, is shown by shot. The anteroposterior projectionof the foot, utilized to examine the foot disease in the past was referred as to the freely-stressed method. However, most of the patients on suspicion of Hallux Valgus get pains while standing with weight-bearing. Additionally, the patients' real conditions can not be diagnosed without standing. it is helpful for us to apply both the foot weight-bearing and the foot non weight-bearing so as to probe the individual difference between the HVA (Hallux valgus angle) and the IMA (1(superscript *) intermetatarsal angle) and further to provide the informative resources concerning the assessment of performing surgery operation. The study include 40 patients who we having Hallux Valgus of different degree, The findings have revealed the significant difference among 40 patients after the method-weight-bearing AP of the foot projection given. The result shown is a contributing cause to the accurate operation relevant to HVA performed by surgeons. And the possibilities of successful operation in HVA (hallux valgus angle) have been enhanced to some extent. The method-weight-bearing AP projection of the foot can administer to choice applicable diorthosis by surgeons and believed productively to reveal the patients' real conditions. In all likelihood, this method is also helpful and it is applicable to clinical trials not only for the purpose of the prevention from the relapse of the disease but also for the purpose having the operation enhanced and strengthened in a successful way.

並列關鍵字

Hallux Valgus ； foot AP weight-bearing projection ； HVA ； IMA