Correlative Study On The Relationship Among The Abductor Hallucis Muscle Strength,Vitamin D Receptor And Hallux Valgus

Objective:This study aims to explore the role of changes in the muscle strength of the abductor hallucis muscle in the occurrence of hallux valgus and the relationship between the changes of vitamin D receptors in the abductor hallucis muscle and the occurrence of hallux valgus.Methods:1.A total of 40 people were included in this study.There were 20 patients with hallux valgus(all females),aged from 40 to 55 years old,average 46.15±4.67 years old,BMI from 19.74 to 22.96kg/m~2,average 21.35±0.98kg/m~2,and 20 volunteer subjects(all females),aged from 40 to 55 years old,average 47.65±4.94 years old,BMI from19.34-22.75kg/m~2,average 21.10±1.01kg/m~2.Patients with hallux valgus were taken as the hallux valgus group,and volunteers were taken as the control group.Using surface electromyography to obtain the maximum isometric contraction percentage(MVIC%)of the abductor hallucis and adductor hallucis muscles respectively,and compare the difference between the abductor hallucis and adductor hallucis MVIC%of the normal foot and the hallux valgus foot.2.A total of 20 cases were included in this study,including 10 cases in each of the hallux valgus group(10 cases of women)and the control group(10 cases of women).The abductor hallucis specimens were collected from the residual limbs of patients with amputations from September 2016 to August 2020 in our hospital.The residual limbs were examined by weight-holding orthographic film.According to the imaging measurement results,those with hallux valgus angle>15°and intermetatarsal angle<9°were classified as hallux valgus group,hallux valgus angle<15°and intermetatarsal angle Those<9°were classified as the control group.A specimen of the abductor hallucis muscle was taken 1-2cm behind the navicular tuberosity of the residual limb,the size was about 5×5×5mm.After the abductor hallucis muscle was obtained,it was stored in a fixative solution(10%neutral formalin).The specimens were embedded in paraffin,sectioned,stained with hematoxylin-eosin(HE).Using Image-Pro Plus 6.0 software to measure the cross-sectional area of the abductor hallucis muscle fiber.Using immunohistochemical staining to detect the expression of vitamin D receptor in the abductor hallucis muscle.The difference between the atrophy of the abductor hallucis and the difference of vitamin D receptor in abductor hallucis between hallux valgus group and control group was analyzed and compared.Results:1.In the hallux valgus group,the abductor hallucis MVIC%=89.07±1.02,the adductor hallucis MVIC%=89.86±0.84.While in the control group,the abductor hallucis MVIC%=92.67±0.64,and the adductor hallucis MVIC%=90.02±0.66.There was significant difference(t=-13.357,p<0.0001)in MVIC%of the abductor hallucis between hallux valgus group and control group,indicating that the muscle strength of abductor hallucis of the hallux valgus foot was weaker than that of the normal foot.While there was no significant difference in adductor hallucis MVIC%between hallux valgus group and control group(t=-0.686,p=0.497).There was no statistical difference between the two groups in age(t=-0.986,p=0.330)and BMI(t=0.795,p=0.432).2.Compared with the control group,the abductor hallucis muscle fibers in the hallux valgus group were significantly atrophied.The cross-sectional area of the abductor hallucis muscle fibers in the hallux valgus group was(2795.57±210.25)μm~2,and the cross-sectional area of the abductor hallucis muscle fibers in the control group was(3918.07±386.87)μm~2.The comparison between the two was statistically significant(t=-8.062,p<0.0001).The number of positive vitamin D receptor staining per 500 cells in the abductor hallucis muscle in the hallux valgus group was 3.00±1.49,while the number of positive vitamin D receptor staining per 500 cells in the abductor hallucis muscle in the control group was15.30±3.30.Compared with the control group,the difference in vitamin D receptors in the abductor hallucis in the hallux valgus group was statistically significant(t=-10.737,p<0.0001),indicating that the content of vitamin D receptors in the abductor hallucis hallux was lower than that in the normal abductor hallucis muscle.Conclusion:1.Decreased muscle strength of the abductor hallucis muscle plays an important role in the occurrence of hallux valgus;2.Decreased vitamin D receptor content in the abductor hallucis muscle is related to the occurrence of hallux valgus.