摘要
目的:探讨跟痛症患者跟骨内侧突骨刺的解剖学特点,分析其形成因素。方法:从跟痛症患者中选取经X线检查确定合并跟骨内侧突骨刺者,拍摄跟骨侧位X线片,测量骨刺的厚度和长度。分析患者的性别和年龄,比较不同性别患者的年龄和不同年龄患者的性别,比较不同侧别、类型跟骨内侧突骨刺的长度及厚度。结果:①不同性别患者的年龄。共纳入113例合并跟骨内侧突骨刺的跟痛症患者,男45例、女68例。男性组年龄(51.80±12.66)岁,女性组年龄(58.03±9.00)岁,男性患者的年龄小于女性(t′=-2.492,P=0.015)。②不同年龄患者的性别。<45岁组男11例(73%)、女4例(27%),45~55岁组男14例(41%)、女20例(59%),>55岁组男20例(31%)、女44例(69%);3组患者性别分布的差异有统计学意义(χ^(2)=9.018,P=0.011),进一步两两比较发现,<45岁组与45~55岁组性别分布的差异无统计学意义(χ^(2)=4.307,P=0.038),45~55岁组与>55岁组性别分布的差异无统计学意义(χ^(2)=0.966,P=0.326),>55岁组的女性占比高于<45岁组(χ^(2)=9.026,P=0.003)。③不同侧别跟骨内侧突骨刺的长度及厚度。跟骨内侧突骨刺,左侧50例、右侧58例、双侧5例。左侧跟骨内侧突骨刺的长度小于右侧[(4.09±1.80)mm,(5.03±1.96)mm,t=2.600,P=0.011]。左侧与右侧跟骨内侧突骨刺厚度的差异无统计学意义[(3.42±1.14)mm,(3.92±1.73)mm,t=1.754,P=0.084]。④不同类型跟骨内侧突骨刺的长度及厚度。单纯跟骨内侧突骨刺93例,跟骨内侧突和跟腱止点处骨刺20例。不同类型跟骨内侧突骨刺长度的差异无统计学意义[(4.74±1.98)mm,(4.19±1.77)mm,t=-1.148,P=0.253]。不同类型跟骨内侧突骨刺厚度的差异无统计学意义[(3.65±1.14)mm,(4.08±2.68)mm,t′=0.698,P=0.493]。结论:跟痛症患者的跟骨内侧突骨刺,左侧骨刺长度小于右侧,两侧骨刺厚度无明显差别,不同类型骨刺的长度及厚度均无明显差别;男性患者的年龄小于女性,55岁以上患者中女性患者比例较高;跟骨内侧突骨刺的形成可能与激素水平变化有关。
Objective:To explore the anatomical characteristics of plantar calcaneal spurs(PCS)at medial process in patients with cal-caneodynia,and to analyze the factors of its formation.Methods:The patients who were diagnosed with PCS at medial process by X-ray ex-amination were selected from the ones with calcaneodynia.The calcaneal lateral X-ray films were taken,and the thickness and length of PCS were measured on the X-ray films.The gender and age of the patients were analyzed.The age of patients were compared between different genders and the gender of patients were compared between different ages.The length and thickness of PCS were compared between different sides and types.Results:One hundred and thirteen patients were included in the study,and they consisted of 45 males and 68 females and ranged in age of 51.80±12.66 years in males and 58.03±9.00 years in females.The male patients were younger than the female patients(t′=-2.492,P=0.015).The patients include 11 males(73%)and 4 female(27%)in group aged less than 45 years,14 males(41%)and 20 females(59%)in group aged from 45 to 55 years,and 20 males(31%)and 44 females(69%)in group aged over 55 years.There was statistical difference in gender distribution between the 3 groups(χ^(2)=9.018,P=0.011).Further pairwise comparison showed that there was no statistical difference in gender distribution between group aged less than 45 years and group aged from 45 to 55 years(χ^(2)=4.307,P=0.038),as well as between group aged from 45 to 55 years and group aged over 55 years(χ^(2)=0.966,P=0.326).The propor-tion of females was higher in group aged over 55 years compared to group aged less than 45 years(χ^(2)=9.026,P=0.003).The PCS located in left calcaneus for 50 patients,right for 58 patients and bilateral for 5 patients.The length of PCS was shorter in left calcaneus compared to the right calcaneus(4.09±1.80 vs 5.03±1.96 mm,t=2.600,P=0.011).There was no statistical difference in thickness of PCS be-tween the left calcaneus and the right calcaneus(3.42±1.14 vs 3.92±1.73 mm,t=1.754,P=0.084).The PCS were merely on medial process in 93 patients and on both medial process and the ending point of tendo calcaneus in 20 patients.There was no statistical difference in the length and thickness of PCS between different types(4.74±1.98 vs 4.19±1.77 mm,t=-1.148,P=0.253;3.65±1.14 vs 4.08±2.68 mm,t′=0.698,P=0.493).Conclusion:In patients with calcaneodynia and PCS,the length of PCS is shorter in left calcane-us compared to the right calcaneus,and the differences in thickness of PCS between bilateral sides and in length and thickness of PCS be-tween different types are not statistically significant.Moreover,the male patients are younger than the female patients.The PCS is more com-mon in females patients aged over 55 years,and its formation may be related to the changes of hormone levels.
作者
黄鲁丰
贺华勇
李杰华
叶永亮
颜仰雪
廖立青
HUANG Lufeng;HE Huayong;LI Jiehua;YE Yongliang;YAN Yangxue;LIAO Liqing(Guangzhou Orthopedic Hospital,Guangzhou 510045,Guangdong,China;Tianhe Hospital of TCM,Guangzhou 510665,Guangdong,China;School of Chinese Medicine of Southern Medical University,Guangzhou 510515,Guangdong,China)
出处
《中医正骨》
2021年第4期51-54,共4页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
跟骨骨刺
足跟痛
解剖
heel spur
heel pain
dissection
