业余马拉松运动员弹簧韧带损伤MR诊断及足弓受损因素分析

MR diagnosis of spring ligament injury in amateur marathoners and analysis of foot arch injury factors

目的:通过应用MR观察业余马拉松运动员的弹簧韧带,分析其在MRI上的显示情况,并分析弹簧韧带损伤后对足弓的影响因素.方法:选取正常志愿者30例为对照组,年龄25~46岁,月跑量7~30 km;60例业余马拉松运动员为观察组,年龄27~48岁,月跑量为80~400 km.对比对照组和观察组一般资料以及弹簧韧带的MR影像表现,Logistic回归分析探讨业余马拉松运动员月跑量、胫骨后肌腱、胫骨前肌腱、腓骨过劳、踝关节牵拉试验对其足弓的影响.结果:两组性别、年龄的一般资料比较无统计学差异(P>0.05).观察组的上内跟舟韧带的影像学分析情况明显高于对照组,差异有统计学意义(P<0.05).观察组的内下斜行跟舟韧带的影像学分析情况与对照组相比差异无统计学意义(P>0.05).Logistic回归分析显示月跑量为业余马拉松运动员足弓受损的影响因子,且月跑量越大足弓受损程度越严重.结论:弹簧韧带损伤是业余马拉松运动员常见的韧带损伤,业余马拉松运动员的足弓损伤可能与大量的跑动训练造成踝关节反复受伤,胫骨后肌、胫骨前肌、腓骨长短肌过度疲劳,弹簧韧带复合体过载密切相关.

Objective:To observe the features of spring ligament of amateur marathoners using MR,and analyze its influence on the foot arch.Methods:Thirty normal volunteers,aged 25~46 years old,with a monthly running volume of 7~30 km,were selected as the control group.Sixty amateur marathoners,aged 27~48 years old,with a monthly running volume of 80~400 km were selected as the observation group.Spring ligament MR imaging(MRI)was performed in the control group and the observation group.The general data and MRI data were compared between the two groups.Logistic regression analysis was performed to explore the influence of monthly running volume,posterior tibial tendon,anterior tibial tendon,fibula strain,and ankle traction test on the observation group foot arch.Result:There was no statistical difference in gender and age between the two groups(P>0.05).In MRI data analysis,the upper medial scaphoid ligament in the observation group was significantly higher than that in the control group(P<0.05).There was no significant difference in the medial and lateral collateral ligaments between the two groups(P>0.05).Logistic regression analysis showed that monthly running volume is an impact factor for marathoner arch damage.The greater the monthly running volume was,the more severe the marathoner arch damaged.Conclusion:Spring ligament injury is a common ligament injury in amateur marathoner.The foot arch damage may be closely related to the repeated ankle joint injury caused by the marathoner extensive running training,the excessive fatigue of the tibialis posterior muscle,the tibialis anterior muscle,and the peroneus brevis short muscle,and the overload of the spring ligament complex.