目的:探讨足底压力测试系统对第1跖楔关节融合术后疗效的分析评价.方法:2013年6月至2014年1月,采用第1跖楔关节融合术治疗16例(20足)拇外翻伴第1序列不稳定患者,均为女性;年龄42～52岁,平均(46.5±2.9)岁;病程3～5年,平均2.5年.另选取20名健康女性为正常对照组,只选取单侧1足,共20足,年龄41～55岁,平均(46.8±4.5)岁.手术前后采用AOFAS评分系统对患足的功能.采用FootScan足底压力测试系统,记录并比较手术前后患足及正常对照组足第1～5跖骨头下的动态峰值压力、压强及冲量指标.结果:所有患者获得随访,时间24～30个月,平均27.4个月.术后患足拇外翻畸形得到纠正,第2跖骨头下痛性胼胝体消失.术前患足AOFAS评分(45.55±12.28)与术后(85.45±6.76)比较差异有统计学意义(P＜0.05);患足第1跖骨头下峰值压力、压强术前较正常组减少,差异有统计学意义(P＜0.05);患足第2骨头下峰值压力、压强及冲量术前较正常对照组增加,差异有统计学意义(P＜0.05);患足第1跖骨头下峰值压力、压强术后较术前增加,差异有统计学意义(P＜0.05),但与正常对照组比较差异无统计学意义(P＞0.05);患足术后第2跖骨头下3项指标较术前明显减少,差异有统计学意义(P＜0.05),与正常对照组比较差异无统计学意义(P＞0.05);手术前后第4、5跖骨头与正常组比较无统计学意义(P＞0.05).结论:第1序列不稳定患足第1、2跖骨头下的压力与正常足有明显区别,行第1跖楔关节融合术可恢复第1、2跖骨头下正常的足底压力,而通过足底压力分析可进一步评价手术疗效.%Objective:To explore plantar pressure measurement system in treating the first ray hypermobility.Methods:From June 2013 to January 2014,16 female patients (20 feet) with hallux valgus with unstable of the first sequence were treated by first tarsometatarsal joint fusion,aged from 42 to 52 years old with an average of (46.5±2.9) years old,the course of disease was from 3 to 5 years.Twenty healthy female (20 feet) were chosen as control group,and single side were only choose,aged from 41 to 55 years old with an average of(46.8±4.5) years old.Preoperative and postoperative AOFAS score was used to evaluate feet function.Plantar pressure measurement system were applied to compare peak value of the dynamic pressure and impulse indicators of affected feet and control normal feet from the first to the fifth head of metatarsal bone.Results:All patients were followed up from 24 to 30 months with an average of 27.4 months.Hallux valgus deformity of affected feet were corrected,pain and swelling of the second head of metatarsal bone were disappeared.There were statistical differences in AOFAS score between preoperative (45.55±12.28) and postoperative (85.45±6.76).There were significant differences in peak pressure,pressure between affected feet and normal feet of the first and second head of metatarsal bone.Postoperative peak pressure,pressure of the first affected head of metatarsal bone were increased than that of before operation,but no differences compared with control group (P＞0.05).Postoperative peak pressure,pressure of the second affected head of metatarsal bone were decreased before operation (P＜0.05),but no meaning compared with control group (P＞0.05).There were no significant differences compared between the forth and fifth affected head of metatarsal bone and control group (P＞0.05).Conclusion:There were obvious differences in pressure of the first and second head of metatarsal bone patients with unstable of the first sequence,the first tarsometatarsal joint fusing could recover plantar pressure of the first and second head of metatarsal bone by plantar pressure measurement system.
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