外反母趾に対する母趾牽引バンド付きアーチパッドの効果について

Efficacy of an Arch Pad with a Big-toe Traction Band in Patients with Hallux Valgus

　対象と目的：31例の外反母趾患者を対象に，外反母趾の変形の矯正目的に作製された鼻緒型装着群(16例)と，外反母趾の痛みに対する免荷を目的に作製したパッド併用型装着群(15例)の8週間の治療効果を比較した．評価項目は，足底分圧計を用いて足部圧全体に対する母趾分圧の比率と足部機能指数(FFI)の改善点数を2群間で比較した．

　結果：4週間の予定治療を達成した28例の母趾分圧は裸足時が27.9±7.2％，鼻緒型装着時が26.0±6.8％パッド併用装着時が17.5±6.4％あった．対応あるt検定では裸足時に比べてパッド併用型は母趾分圧を有意に低下させた(p＜0.0001)が，鼻緒型では有意な変化はなかった．8週間治療前後でのFFIの変化は鼻緒型装着群では有意な改善はなかったが，パッド併用型装着群では有意な改善があった(p＝0.003)．

　まとめ：上記結果から外反母趾の装具療法では変形の矯正とともに病変部への免荷機能を有する装具のほうが変形矯正単独装具より優れた臨床効果を示すと考えた．

　We evaluated redistribution of the foot pressure of 31 patients with hallux valgus (HV) when wearing a big-toe traction band with an arch pad (test band) or toe-separated band (control band).　Big-toe pressure as a percentage of total foot pressure was significantly lower in the test band group (17.5±6.4%) than in the control band group (26.0±6.8%).　The test band or control band was used to treat 28 of the 31 HV patients for four weeks.　The Foot Function Index (FFI) at the final assessment was compared with the FFI at baseline in both the test band group and control band group.　A significant improvement in the FFI was observed in the test band group (n＝13) (p＝0.003), but no significant difference was found in the control band group (n＝15).　We concluded that decreasing big-toe pressure by wearing the arch pad is useful for improving HV clinically.