Objective

Hallux valgus, the lateral deviation of the great toe, can result in poor balance, impaired mobility and is an independent risk factor for falls. This research aims to compare the prevalence of hallux valgus in subpopulations of medieval Cambridge, England, and to examine the relationship between hallux valgus and fractures to examine the impact of impaired mobility and poor balance caused by this condition.

Materials

177 adult individuals from four cemeteries located in Cambridge, England.

Methods

Human remains were macroscopically and radiographically assessed.

Results

Hallux valgus was identified in 18 % of individuals and was significantly more common during the 14th–15th centuries than the 11th–13th centuries. The highest prevalence was observed in the friary (43 %), followed by the Hospital (23 %), the rurban parish cemetery (10 %), and the rural parish cemetery (3%). Fractures from falls were significantly more common in those with hallux valgus than those without.

Conclusion

The increased prevalence of hallux valgus identified in individuals from the 14th to 15th centuries coincided with the adoption of new footwear with pointed toes. Those that adopted this fashion trend appear to have been more likely to develop balance and mobility problems that resulted in an increased risk of falls.

Significance

This is the first study to explore the relationship between foot problems and functional ability by studying hallux valgus in archaeological assemblages.

Limitations

Falls are complex and determining the mechanism of injury in human skeletal remains is not always possible.

Further research

Fracture prevalence rates may have been affected by biological factors and underlying pathological conditions.

中文翻译：

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漂亮的鞋子和痛苦的脚：中世纪英国剑桥的拇趾外翻和骨折风险

客观的

拇趾外翻（大脚趾的横向偏差）会导致平衡能力差、活动能力受损，并且是跌倒的独立危险因素。本研究旨在比较中世纪英国剑桥亚人群中拇外翻的患病率，并研究拇外翻与骨折之间的关系，以探讨这种情况引起的活动能力受损和平衡能力差的影响。

材料

来自英国剑桥四个墓地的 177 名成年人。

方法

对人类遗骸进行宏观和放射学评估。

结果

18% 的人患有拇外翻，并且在 14 至 15 世纪比 11 至 13 世纪更为常见。修道院的患病率最高（43%），其次是医院（23%）、城市教区公墓（10%）和农村教区公墓（3%）。患有拇外翻的人比没有拇外翻的人更容易发生跌倒骨折。

结论

14 世纪至 15 世纪，随着新式尖头鞋的采用，拇外翻的患病率不断增加。那些采用这种时尚趋势的人似乎更有可能出现平衡和行动问题，从而导致跌倒的风险增加。

意义

这是第一项通过研究考古组合中的拇外翻来探讨足部问题与功能能力之间关系的研究。

局限性

跌倒的情况很复杂，确定人类骨骼遗骸的损伤机制并不总是可能的。

进一步的研究

骨折患病率可能受到生物因素和潜在病理条件的影响。