拇趾外翻足弓形态参数与第二跖骨头下胼胝体形成的相关性分析

Correlation Analysis between Morphological Parameters of Hallux Valgus Arch and Occurrence of Corpus Callosum under the Second Metatarsal Head

目的:探讨拇趾外翻足弓形态参数与第二跖骨头下胼胝体形成的相关性。方法:选择2020年2月至2023年3月收治的180例(360足)拇趾外翻患者为研究对象,根据X线检查结果将患者按拇趾外翻程度分为轻中度组(127例)和重度组(53例),比较两组患者的一般资料及拇趾外翻足弓形态参数,通过Logistic回归分析和构建校正模型,分析患者足弓形态参数与重度拇趾外翻的关系;另根据第二跖骨头下有无胼胝体将患者分为有胼胝体组(66例)和无胼胝体组(114例),比较两组患者的一般资料及拇趾外翻足弓形态参数,采用分层回归模型分析拇趾外翻足弓形态参数对第二跖骨头下胼胝体形成的影响;采用广义估计方程模型分析拇趾外翻患者第二跖骨头下胼胝体形成的影响因素。结果:轻中度组与重度组患者拇趾外翻角(HVA)、第一跖和第二跖骨间角(IMA1-2)、前弓角、内弓顶角差异均有统计学意义(P<0.05);通过Logistic回归分析可知,校正混杂因素后患者足弓形态参数与重度拇趾外翻的OR值分别为1.905,2.317,0.769和2.147,得出拇趾外翻角、第一跖和第二跖骨间角、前弓角、内弓顶角是重度拇趾外翻的独立影响因素(P<0.05);与无胼胝体组患者相比,有胼胝体组拇趾外翻角、第一跖和第二跖骨间角、内弓顶角更大,前弓角更小,差异均有统计学意义(P<0.05);分层回归分析结果显示,拇趾外翻角、第一跖和第二跖骨间角、前弓角、内弓顶角会对第二跖骨头下胼胝体形成产生显著影响(P<0.05);广义估计方程模型分析结果显示,拇趾外翻角、第一跖和第二跖骨间角、前弓角、内弓顶角均显著影响拇趾外翻患者第二跖骨头下胼胝体形成(P<0.05)。结论:拇趾外翻足弓形态参数与第二跖骨头下胼胝体形成之间存在一定的相关性,其中拇趾外翻角、第一跖和第二跖骨间角、前弓角、内弓顶角的变化会导致第二跖骨头下胼胝体形成。

Objective:To investigate the correlation between the morphological parameters of the hallux valgus arch and the occurrence of the corpus callosum under the second metatarsal head.Methods:A total of 180 patients(360 feet)with hallux valgus admitted from February 2020 to March 2023 were selected as the research objects.According to the results of X-ray examination,the patients were divided into mild-moderate group(127 cases)and severe group(53 cases).The general data and the morphological parameters of the hallux valgus arch of the two groups were compared.Logistic regression analysis and correction model were used to analyze the relationship between the foot arch morphological parameters and severe hallux valgus.According to the presence or absence of the corpus callosum under the second metatarsal head,the patients were divided into the corpus callosum group(66 cases)and the non-corpus callosum group(114 cases).The general data and the morphological parameters of the hallux valgus arch were compared between the two groups.The generalized estimating equation(GEE)model was used to analyze the influencing factors of the occurrence of corpus callosum under the second metatarsal head in patients with hallux valgus.Results:There were significant differences in hallux valgus angle(HVA),1st/2nd intermetatarsal angle(IMA1-2),anterior arch angle and medial arch apex angle between the mild to moderate group and the severe group(P<0.05).Logistic regression analysis showed that after adjusting for confounding factors,the OR values of the arch morphological parameters and severe hallux valgus were 1.905,2.317,0.769 and 2.147,respectively.HVA,IMA1-2,anterior arch angle and medial arch apex angle were independent influencing factors for severe hallux valgus(P<0.05).Compared with the patients without corpus callosum,the patients with corpus callosum had significantly larger HVA,IMA1-2,and medial arch apex angle and significantly smaller anterior arch angle(P<0.05).Hierarchical regression analysis showed that HVA,IMA1-2,anterior arch angle,and medial arch apex angle had significant effects on the occurrence of the corpus callosum under the second metatarsal head(P<0.05).GEE model analysis showed that HVA,IMA1-2,anterior arch angle and medial arch apex angle significantly affected the occurrence of corpus callosum under the second metatarsal head in patients with hallux valgus(P<0.05).Conclusion:There is a certain correlation between the morphological parameters of hallux valgus foot arch and the occurrence of the corpus callosum under the second metatarsal head.The changes of HVA,IMA1-2,anterior arch angle,and medial arch apex angle can lead to the occurrence of the corpus callosum under the second metatarsal head.