發(fā)布時(shí)間：2019-03-20 12:21

【摘要】：研究目的： 應(yīng)用X線(xiàn)數(shù)字?jǐn)鄬尤诤蠑z影方法獲得后足冠狀位應(yīng)力位的X線(xiàn)圖像，根據(jù)圖像結(jié)果提出后距跟角的測(cè)量方法，并將其應(yīng)用于兒童柔韌性扁平足的測(cè)量，以及與臨床檢查中的RCSP值及傳統(tǒng)Ｘ線(xiàn)側(cè)位應(yīng)力位片測(cè)量柔韌性扁平足的方法進(jìn)行比較，探索后足冠狀位應(yīng)力位的X線(xiàn)圖像的應(yīng)用價(jià)值。 方法： 1：兒童后足冠狀應(yīng)力位X線(xiàn)圖像的獲取及研究 按照足踝外科協(xié)會(huì)的標(biāo)準(zhǔn)選擇正常足、高弓足、扁平足3人，進(jìn)行后足冠狀位應(yīng)力位Ｘ線(xiàn)數(shù)字?jǐn)鄬尤诤蠑z影，分別獲得正常足、扁平足、高弓足的后足冠狀位的X線(xiàn)圖像，比較三者后足冠狀位X線(xiàn)圖像上跟骨與距骨之間的縱向軸、橫徑以及后距跟角的改變。 2：兒童后足冠狀應(yīng)力位X線(xiàn)圖像在兒童扁平足中的應(yīng)用研究 參照RCSP值和Meary角關(guān)于足弓的評(píng)判標(biāo)準(zhǔn)，從2013年9月～12月在湖南省人民醫(yī)院小兒骨科門(mén)診就診的患兒中選擇柔韌性扁平足患兒27例共54個(gè)足作為實(shí)驗(yàn)組；正常人群的志愿者19例共38個(gè)足（經(jīng)倫理委員會(huì)的批準(zhǔn)及征求志愿者的知情同意）作為正常組。患兒及志愿者年齡均分布在3歲至7歲之間。正常組和實(shí)驗(yàn)組均進(jìn)行臨床檢查及Ｘ線(xiàn)攝影（包括后足冠狀位應(yīng)力位Ｘ線(xiàn)及足側(cè)位應(yīng)力位Ｘ線(xiàn)），獲取正常組與實(shí)驗(yàn)組的后距跟角α、Meary角β、RCPS值γ。 結(jié)果： 1：本研究中從后足冠狀位應(yīng)力位Ｘ線(xiàn)圖像上能清晰的顯示脛距關(guān)節(jié)、距跟關(guān)節(jié)之間的關(guān)節(jié)間隙及在后足冠狀面上脛骨、距骨、跟骨之間的生物力學(xué)關(guān)系：對(duì)于高弓足的患兒從本研究中獲得的后足冠狀應(yīng)力位的圖像上我們發(fā)現(xiàn)足的跟骨與距骨之間的縱向軸變長(zhǎng)、橫徑變短；柔韌性扁平足患兒的后足冠狀位應(yīng)力位Ｘ線(xiàn)圖像上顯示距骨頭下降，跟骨外翻。 2：正常組與實(shí)驗(yàn)組的年齡比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)，，正常組α、β、γ均低于實(shí)驗(yàn)組，兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 3：α與β、α與γ之間均存在正相關(guān)性。相關(guān)系數(shù)分別為（r=0.891，P0.01）、（r=0.887, P0.05）。 4：本實(shí)驗(yàn)中正常組后距跟角α的范圍為8.54°~10.01°。 結(jié)論： 1、后足冠狀位應(yīng)力位X線(xiàn)圖像能清楚地顯示脛骨、距骨和跟骨在冠狀位的相互關(guān)系；可能對(duì)評(píng)價(jià)兒童柔韌性扁平足、高弓足有意義。 2、后足冠狀位應(yīng)力位X線(xiàn)上測(cè)量的后距跟角與足側(cè)位應(yīng)力位X線(xiàn)上Meary角、以及臨床檢查的RCPS值具有一致性，有望成為兒童柔韌性扁平足的測(cè)量和評(píng)估指標(biāo)。
[Abstract]:Objective: to obtain the X-ray images of stress position in posterior crown position by digital tomography fusion X-ray, and put forward the measurement method of heel angle according to the image results, and apply it to the measurement of flexible and flat foot in children. Compared with the RCP value in clinical examination and the traditional X-ray lateral stress potential film, the value of X-ray images in posterior crown position stress position was explored in order to explore the application value of the X-ray images of posterior crown position stress position in the measurement of flexible and flat foot. Methods: 1. X-ray images of posterior foot coronal stress position were obtained and studied in 3 children with normal foot, high arch foot and flat foot according to the criteria of the Society of ankle surgery. The coronal X-ray images of normal foot, flat foot and high arch foot were obtained respectively. The longitudinal axis, transverse diameter and heel angle of calcaneus and talus on coronal X-ray images of three hind feet were compared. Application of coronal stress X-ray images of the posterior foot in children with flat foot. Reference to the evaluation criteria of RCSS and Meary angle with regard to the arch of the foot. From September to December 2013, 54 feet of 27 children with flat feet were selected as the experimental group in the Department of Pediatric Orthopedics, people's Hospital of Hunan Province. A total of 38 feet (approved by the ethics committee and informed consent of volunteers) were selected as the normal group. The ages of children and volunteers ranged from 3 to 7 years old. Both normal and experimental groups were examined by clinical examination and X-ray (including posterior foot coronal stress X-ray and foot lateral stress X-ray). The calcaneal angle 偽, Meary angle 尾 and RCPS value 緯 were obtained from normal group and experimental group. Results: 1: in this study, the tibiotalar joint, talus-calcaneal joint and the tibia and talus on the coronal plane of the hind foot could be clearly displayed from the X-ray images of the posterior foot on the coronal plane. Biomechanical relationship between calcaneus: we found that the longitudinal axis between calcaneus and talus was longer and the transverse diameter was shorter in the images of coronal stress position of hind foot in children with high arched foot. X-ray images of posterior foot coronal stress in flexible flat foot children showed declination of talus and valgus of calcaneus. 2: there was no significant difference in age between the normal group and the experimental group (P0.05), while 偽, 尾, 緯 in the normal group were lower than those in the experimental group, and there was significant difference between the two groups (P0.05). 3: there is a positive correlation between 偽 and 尾, 偽 and 緯. The correlation coefficients were (r = 0.891, P0.01), (r = 0.887, P0.05). 4: the range of calcaneal angle 偽 in normal group ranged from 8.54 擄to 10.01 擄. Conclusion: 1 X-ray images of posterior foot in coronal plane can clearly show the relationship among tibia, talus and calcaneus in coronal plane, which may be of significance in evaluating flexible and flat foot and high arch foot in children. 2. The posterior heel angle measured on the coronal plane of the hind foot was consistent with the Meary angle on the lateral position of the foot, as well as the RCPS value of the clinical examination, which is expected to be used as an index for the measurement and evaluation of the flexible and flattened foot in children.
【學(xué)位授予單位】：南華大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 王義龍,馬兆龍,王民,劉國(guó)強(qiáng),史社會(huì),段保國(guó);踝關(guān)節(jié)與距下關(guān)節(jié)矢狀斷層解剖學(xué)[J];解剖學(xué)雜志;2005年01期

2 回俊嶺;陳樹(shù)君;夏鳳歧;路蘭紅;牟兆新;井蘭香;;扁平足X線(xiàn)片測(cè)量法與比值法、三線(xiàn)法的比較[J];解剖學(xué)雜志;2007年02期

3 耿敬標(biāo);胡東;周軻;朱昭環(huán);;環(huán)樞椎的X線(xiàn)數(shù)字?jǐn)鄬尤诤铣上穹治鯷J];山西醫(yī)藥雜志;2011年10期

4 魏勇;劉宇;;距骨下關(guān)節(jié)功能解剖和運(yùn)動(dòng)研究進(jìn)展[J];體育科學(xué);2008年12期

5 周軍杰;俞光榮;曹成福;紀(jì)斌;成翔宇;;距下關(guān)節(jié)在成人足三維運(yùn)動(dòng)中的力學(xué)研究[J];中國(guó)臨床解剖學(xué)雜志;2006年06期

6 王路軍;張建中;;側(cè)位距骨第一跖骨角研究進(jìn)展[J];中國(guó)醫(yī)學(xué)影像學(xué)雜志;2012年07期

本文編號(hào)：2444212