The subtalar joint movement between the talus and calcaneus is restricted in patients with talocalcaneal coalition (TCC). When the motion of the subtalar joint is restricted, shock absorption in the foot decreases, leading to pain during walking. Resection methods to maintain subtalar motion by removing abnormal unions have been proposed. The purpose of this study was to analyze the joint kinematics of patients who underwent TCC resection and to quantitatively evaluate the results of the surgery based on the measured kinematics. Joint kinematics of five patients with TCC were obtained using a biplane fluoroscopic imaging system and an intensity-based two-/three-dimensional registration method. The joint kinematics of the tibiotalar and subtalar joints and the tibiocalcaneal motion during the stance phase of walking were obtained. From the kinematics of the hindfoot joints, the inversion/eversion range of motion (ROM) of the patients before and after resection was statistically analyzed using the Wilcoxon signed-rank test to test whether TCC resection improved the ROM. During the loading response period, the eversion ROM of the subtalar joint and tibiocalcaneal motion significantly increased postoperatively. In addition, a significant postoperative increase was observed in the subtalar and tibiocalcaneal inversion ROM during the pre-swing period. TCC resection surgery increased the ROM of the subtalar joint, which in turn contributed to the increase in tibiocalcaneal ROM. Increased subtalar and tibiocalcaneal ROM could result in increased shock attenuation and may be a contributing factor to pain relief during walking.

中文翻译：

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距跟联合切除后后足关节运动学分析

距跟联合 (TCC) 患者的距骨和跟骨之间的距下关节运动受到限制。当距下关节的运动受到限制时，足部的减震能力下降，导致行走时疼痛。已经提出了通过去除异常连接来维持距下运动的切除方法。本研究的目的是分析接受 TCC 切除术的患者的关节运动学，并根据测量的运动学定量评估手术结果。使用双平面荧光成像系统和基于强度的二维/三维配准方法获得了 5 名 TCC 患者的关节运动学数据。获得了胫距和距下关节的关节运动学以及步行站立阶段的胫跟运动。从后足关节的运动学角度，采用Wilcoxon符号秩检验对患者切除前后的内翻/外翻活动范围（ROM）进行统计分析，以检验TCC切除是否改善了ROM。在负荷反应期间，术后距下关节外翻活动度和胫跟运动显着增加。此外，在预摆动期间，观察到距下和胫跟内翻 ROM 的术后显着增加。 TCC切除手术增加了距下关节的ROM，进而导致胫跟骨ROM的增加。距下骨和胫跟骨活动度的增加可能会导致冲击衰减增加，并且可能是步行时缓解疼痛的一个因素。