【骨科 关节资料】hallux valgus 拇外翻.pptxVIP

足的功能Functions of the Foot维持正立的体位Maintain up-right posture朝前行走 Forward propulsion缓冲Impact - Shock absorbtion在不规则的地面行走Accomodation to surface irregularities旋转Torque convertion ( 一足固定的转体运动i.e: body rotation on fixed foot) 足的不同部分The different parts of the Foot前足Forefoot (1)跖骨＋趾骨Métatarsal + Phalangies中足Midfoot (2)骰骨＋舟骨＋楔形骨 Cuboid + Scaphoid + Cuneiform后足Hindfoot (3) (rarefoot or backfoot)距骨＋跟骨Talus + Calcaneus123 前足The FOREFOOT 骨The bones 前足由下列19块骨组成Forefoot is composed of 19 bones as follow:5跖骨5 metatarsals5 足趾5 digits 除大踇趾由2块趾骨构成外其余足趾均由3块趾骨构成 Composed of 3 phalangies each except for the big toe which has only 2DigitsMetatarsals 常用方位General orientationDistalProximalMedialLateralDistalProximalDorsalPlantar侧面观Lateral view背面观Dorsal view 普通运动General motion内收dduction: 足向人体轴线旋转（中心位）rotation of foot toward body axis (medial side)外展Abduction: 足背离人体轴线旋转（外侧方）rotation of foot away from body axis (lateral side)中立位Neutral position General motion内翻Inversion:反掌Supination (sole going upward) + 内收Adduction + 背伸Extension外翻Eversion:足掌向下Pronation (sole going downward) + 外展Abduction + 跖屈Flexion背伸Extension跖屈Flexion 足与步态的轴线形成约15° 的夹角Angle between gait axis and foot axis: ~ 15°步态The gait行走时足部的压力变化Pressure point during the gait足的轴线Foot axis步态的轴线Axis of the gait Morpho-types 埃及形足Egyptian foot 方形足Square foot 希腊形足Greek foot3种常见的前足形态There are 3 commun types of morphologies that are easily recognizable in the forefoot Morpho-types埃及形Egyptian :61% men - 56% Women方形Square : 24% men - 28% Women希腊形Greek : 15% men - 16% Women3种足形决定了前足病变的病理学基础 The 3 types of feet, will determine part of the possible pathologies developpment associated with the forefoot踇外翻Hallux Valgus …... Normal Conditions1st MTP周围软组织 的动态平衡Soft tissues which generate dynamic forces across the 1st MTP are :平衡either balanced( 踇展肌 vs 踇内收肌) ( abductors vs adductors)以跖骨头机械轴为中心的 FHL EHL centered on the mechanical axis of the metatarsal head ( FHL EHL)关节囊可对抗外来的形变压力 Capsular restai