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首页> 外文期刊>Foot and ankle international >Hindfoot coronal alignment: a modified radiographic method.
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Hindfoot coronal alignment: a modified radiographic method.

机译：后足冠状动脉对准：一种改进的射线照相方法。

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Accurate clinical evaluation of the alignment of the calcaneus relative to the tibia in the coronal plane is essential in the evaluation and treatment of hindfoot pathologic condition. Previously described radiographic views of the foot and ankle do not demonstrate the true coronal alignment of the calcaneus relative to the tibia. Some of these views impose on the patient an unnatural posture that itself changes hindfoot alignment, whereas other methods distort the coronal alignment by the angle of the x-ray beam. Our purpose was to develop a modified radiographic view and measurement method for determining an angular measurement of hindfoot coronal alignment based on a cadaver study of the radiographic characteristics of the calcaneus and motion analysis of standing subjects. The view was obtained by having the subject stand on a piece of cardboard to create a foot template. The template was then positioned so that each foot was x-rayed perpendicular to the cassette while still maintaining the natural base of support. A method using multiple ellipses was developed to determine more accurately the coronal axis of the posterior calcaneus. A study using cadavers was performed in which radio-opaque markers were placed on multiple bony landmarks on the calcaneus. The tibia was held fixed in a vertical position, and the foot was x-rayed using the above techniques in different degrees of rotation without changing the relation of the calcaneus to the tibia. The radiographs of the modified Cobey and our view were examined to verify which markers were visible at different angles of rotation and how the hindfoot alignment measurements changed with foot rotation. To define further the differences between the views, an analysis of postural stability was conducted while the subjects were standing with the feet in the positions for imaging both the Buck modification of the Cobey view and our hindfoot alignment view. The combined results of the cadaver, radiographic measurement, and postural stability segments of the study reveal that this coronal hindfoot alignment view and measurement method is reproducible, more closely measures "true" coronal hindfoot alignment, and is more clinically applicable because the alignment is measured while the patient is standing with a normal angle and base of stance. The modified radiographic measurement method relies on posterior calcaneal anatomic landmarks, is less affected by rotation of the foot and ankle, and is reproducible between observers.
机译：跟骨相对于胫骨在冠状平面内对齐的准确临床评估对于评估和治疗后足病理状况至关重要。先前描述的脚和脚踝的射线照相图未显示跟骨相对于胫骨的真正冠状对准。这些视图中的一些向患者施加了不自然的姿势，该姿势本身改变了后脚的对齐方式，而其他方法则通过X射线束的角度扭曲了冠状对齐方式。我们的目的是根据尸体对跟骨放射线特征的尸体研究和站立受试者的运动分析，开发一种改进的放射线图像和测量方法，用于确定后足冠状位的角度测量。通过让受试者站在一块纸板上以创建脚模板来获得视图。然后放置模板，使每只脚垂直于暗盒进行X射线检查，同时仍保持自然的支撑基础。开发了一种使用多个椭圆的方法来更准确地确定后跟的冠状轴。使用尸体进行了一项研究，其中将不透射线的标记物放在跟骨上的多个骨性标记上。将胫骨固定在垂直位置，并使用上述技术以不同的旋转角度对脚进行X射线检查，而不会改变跟骨与胫骨的关系。检查了改良的Cobey的X射线照片和我们的视野，以验证哪些标记在不同的旋转角度下可见，以及后脚对位测量值如何随脚旋转而变化。为了进一步定义视图之间的差异，在受试者站立时双脚站立的位置进行了姿势稳定性分析，以对Cobey视图的Buck修改和我们的后足对齐视图进行成像。研究的尸体，射线照相测量结果和姿势稳定性部分的综合结果显示，这种冠状后脚对准视图和测量方法是可重现的，可以更精确地测量“真实的”冠状后脚对准，并且由于对准可以测量，因此在临床上更适用当患者以正常角度和站姿站立时。改进的射线照相测量方法依赖于后跟骨解剖标志，受脚和踝旋转的影响较小，并且在观察者之间可重现。

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