X線撮影を用いた荷重下での足部評価  [in Japanese] Foot evaluation under weight bearing using roentgenogram  [in Japanese]

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横足根関節(Chopart関節)を境にして、足部を大きく前足部と後足部にわけ、その機能を運動学的に評価した。後足部は距骨下関節の動きを反映した内、外反を示し、前足部は横足根関節や以遠の足根中足関節(Lisfranc関節)などの動きが反映される。また後足部の肢位(動き)は横足根関節を介して前足部の可動性に影響を及ぼす。この後足部の肢位は、距骨下関節を介して足部全体の機能に影響を及ぼす可能性がある。足部の機能を評価する際、前足部と後足部のそれぞれの動きを捉え、身体動作の際の足部や下腿の筋の作用も合わせて機能評価する必要がある。そこで、2つの下肢荷重位の条件下で足部・足関節のX線撮影を行い、後足部や前足部の動きや肢位の変化を測定した。縦アーチ高の計測には横倉法(内側縦アーチ : C点、N点、L点、外側縦アーチ : f点、b点、m点、)を用い、後足部はX線画像上に踵骨の外側縁を確認し、脛骨に対する動きを計測した。結果、足部縦アーチは前足部に荷重することにより低下し、踵骨の外転または内転方向に動く傾向が認められた。また後足部(踵骨の外転)と前足部(縦アーチの低下)の動きには関連性があり、有意な相関(C点、p=0.003、N点、p=0.009、L点、p=0.003、f点、p=0.006)が認められた。

We evaluated the function of the foot kinesiologically dividing it largely into two parts, fore- and midfoot (We call these parts as forefoot later on) and hindfoot, rear part from Chopart joint. The hindfoot reflects the movement of subtalar joint, while the forefoot shows the movement of the foot distal to the Chopart joint. The range of motion of the hindfoot gives influence to the motion of forefoot. When we intend to evaluate the function of the foot, it is necessary totally to examine the movement of those two parts (fore- and hindfoot), including the muscle activities of the lower thigh at the time of physical activity. In terms of this viewpoint, the deviation of tarsal bones of the fore- and hindfoot were measured using roentgenogram of the foot taken under weight bearing. As the results, the certain tendency were noted between the change of hight of the longitudinal arch and calcaneal abduction and adduction, and also several relationships were found in the deviation of tarsal bones in fore- and hindfoot. The correlation was recognized between the decrease of longitudinal arch and calcaneal abduction (C point, p=0.003, N point, p=0.009, L point, p=0.003, f point, p=0.006). Based on mentioned results above, further research was performed in terms of kinetic points of view to examine the foot function.


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