摘要
目的 探讨三维动态的足底压力分析技术在跟骨骨折术后疗效评估中的应用价值。方法随访24例经切开复位内固定术治疗的单侧跟骨关节内骨折患者，按照美国足踝外科协会的踝后足评分标准（AOFAS ankle hindfoot scale）及Maryland足部评分标准（Maryland‰tscore，MFS）进行足踝功能评分；应用三维动态足底压力分析系统（F-scan mobile，teksean，USA）测量足底总峰值压力及足足母趾、第1—5跖骨头、中足、后足等7个解剖区域的平均峰值压力。根据足踝评分结果分组比较分析患者健足与患足的足底峰值压力分布差异。结果本组随访时间16～20个月，平均17．8个月。在AOFAS及Maryland评分为优、良的患者组内，患者健足在1个步态周期中的平均峰值压力总和与患足峰值压力总和近似（P〉0．05）；7个不同解剖区域平均峰值压力除中足外，差异具有统计学意义（P＜0．05）；患足跨趾、第1～5跖骨头平均峰值压力明显增高，足跟部峰值压力减小。在可、差的患者组内，患者健足的平均峰值压力总和与患足峰值压力总和近似（P〉0．05），7个不同解剖区域平均峰值压力分布呈多样性变化，3例患足中足压力明显高于健足，2例患足前后足峰值压力均增高，1例患足足底峰值压力向足第1序列倾移。结论三维动态的足底压力分析技术有助于跟骨骨折术后病理力学早期变化的诊断及常见并发症的个性化治疗。
Objective To explore the value of three-dimensional dynamic plantar pressure analysis in outcome measurement after calcaneal fractures. Methods Twenty-four patients with calcaneal fractures treated with open reduction internal fixation （ORIF） were followed up for evaluating ankle function based on Ankle Hindfoot Scale （AOFAS） and Maryland Foot Score （MFS）. The three-dimensional dynamic pedography （F-scan Mobile, Tekscan, USA） was used to calculate and analyze mean peak pressures of seven anatomical areas including hallux, metatarsal head, midfoot and hindfoot. The distribution difference of peak pressures was compared between the healthy feet and injured feet according to index. Results Follow-up lasted for 16-20 months （ mean 17.8 months）. In the group with excellent and good AOFAS and MFS, there showed no significant difference of sum of peak pressure between the healthy feet and injured feet （ P 〉 0. 05 ）. But the obvious difference was shown of plantar peak pressure distribution （ P 〈 0. 05 ） , except midfoot. The plantar peak pressures of hallux and metartasal heads of injured feet were increased and those of the heel were decreased. In the group with fair and poor, the difference of plantar peak pressure displayed multiplicity in seven different anatomical areas. There were three patients with increased peak pressure in midfoot, two with increased peak pressure in forefoot and hindfoot and one with peak pressure displaced to the first ray in forefoot. Conclusion The three-dimensional dynamic plantar pressure analysis may therefore be a useful tool for detecting the early tiny change of pathomechanics in these patients and for individual treatments of frequent complications.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2008年第1期22-27,共6页
Chinese Journal of Trauma
关键词
跟骨
骨折固定术
内
疗效评估
压力
Calcaneus
Fracture fixation, internal
Outcome assessment
Pressure
