らいにおける踵骨骨梁のX線的変化について

抄録

The important factors closely relating to the structure of calcaneus trabecula are generally considered the static conditions, namely the charged pressure imposed by standing and/or walking and the traction force by muscle movement of lower half of the body at that time.
As frequently, leprosy accompanies with peroneal palsy (so-called as drop foot), calcaneus fracture, deformity in foot joint (Charcot's joint in particular), secondary foot joint union (triple-or pantalar-arthrodesis), secondary amputation of metatarsal part or their combinations. (or above combinations)
All of the above mentioned static conditions are considered to have a close relation with the structure of calcaneus trabecula.
Therefore, radiological studies on changes in calcaneus trabecula have been carried out on the deformed feet in leprosy.
The results are as follows :
(1) Even in the old peroneal palsy cases, if the form of longitudinal arch is slightly decomposed, no effects are observed on the trabecula a, C1 and/or C2 due to steppage gait. The pressure by standing and/or walking which goes through the longitudinal axis of the tibia, further through the center of the foot joint, is ramified (spreaded) to each condition in the metatarsal part and tuber calcanei and, as the trabecula a, C1 and C2 coincide with their own routes respectively, the pressure in the stance phase with the greatest pressure imposed by standing and/or walking is considered to show normal ramification, even in the case of steppage gait.
Even if the joint condition is normal in the stance phase, the trabecula b and/or C2 tends to become coarser when the foot joint is fixed. This seems as the fact of the pressure imposed by standing and/or walking, which goes through the longitudinal axes of the tibia, is not ramified toward the metatarsal part but perpendicularly to the bottom of the calcaneus.
(2) Excepting for the peroneal palsy cases (the majority of the cases) and calcaneus fracture cases with normal Bohler angle, the trabecula d1 and d2 have been found to be weakened or disappearing in almost all studied cases. This seems as these trabeculae have relations with the traction force of the sole muscles. Also, as the calcaeus frequently occurs in leprosy patients, these trabeculae cross the tabecula b, C1 and C2 to make the skeletal structure strong.
(3) As the contructure of calcaneus tendon or loss of its function, the trabecula e markedly increased its disappearing tendency,
As the above, this trabecula is considered to have a closed correlation with the traction force of the calcaneus tendon.