Document Detail


Radiographic measurements in patients with hallux valgus before and after proximal crescentic osteotomy.
MedLine Citation:
PMID:  19487514     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Radiographic measurements such as those of the hallux valgus angle and the intermetatarsal angle are essential parameters for assessing the severity of hallux valgus deformities and the extent of surgical correction required. However, to our knowledge, no study has investigated the reliability of the measurements that are made radiographically before and after a proximal crescentic osteotomy of the first metatarsal. The purpose of the present study was to investigate the intraobserver and interobserver reliability of different methods that are used to measure the angles and to determine the most reliable method. METHODS: We selected twenty preoperative and twenty postoperative dorsoplantar weight-bearing radiographs for patients who had undergone a proximal crescentic osteotomy of the first metatarsal. Three foot and ankle surgeons measured the hallux valgus angle and the intermetatarsal angle with use of five different methods. We calculated the intraobserver and interobserver correlation coefficients and agreement to determine the most reliable method. RESULTS: Significant differences were observed among the methods with regard to the postoperative hallux valgus angle (p < 0.05) and the preoperative and postoperative intermetatarsal angles (p < 0.01 for both). The method in which a line connecting the centers of the first metatarsal head and the proximal articular surface of the first metatarsal was used to define the longitudinal axis of the first metatarsal yielded the highest intraobserver and interobserver correlation coefficients for the preoperative hallux valgus and intermetatarsal angles and the postoperative hallux valgus angle. For this method alone, the intraobserver and interobserver agreements for the angular measurements were found to be >80%. CONCLUSIONS: A line connecting the centers of the first metatarsal head and the proximal articular surface of the first metatarsal to define its longitudinal axis yields the best intraobserver and interobserver reliability for the measurement of the hallux valgus and intermetatarsal angles. Therefore, this method can be recommended for evaluating radiographs before and after a proximal crescentic osteotomy performed for the treatment of hallux valgus.
Authors:
Hiroaki Shima; Ryuzo Okuda; Toshito Yasuda; Tsuyoshi Jotoku; Naoshi Kitano; Mitsuo Kinoshita
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  91     ISSN:  1535-1386     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-02     Completed Date:  2009-07-08     Revised Date:  2010-10-25    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1369-76     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopedic Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, Japan. ort125@poh.osaka-med.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analysis of Variance
Cohort Studies
Female
Hallux Valgus / radiography*,  surgery*
Humans
Male
Metatarsal Bones / radiography*,  surgery
Middle Aged
Observer Variation
Osteotomy / adverse effects,  methods*
Postoperative Care
Preoperative Care
Probability
Sensitivity and Specificity
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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