Pronation on weightbearing radiographs does not correlate with pronation from weightbearing CT scans.

Autor: Patel TJ; Hospital for Special Surgery, New York, NY, United States., Conti MS; Hospital for Special Surgery, New York, NY, United States., Caolo KC; Hospital for Special Surgery, New York, NY, United States., Miller MC; University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA, United States., Conti SF; Orthopaedic Specialists - UPMC, Pittsburgh, PA, United States., Ellis SJ; Hospital for Special Surgery, New York, NY, United States. Electronic address: elliss@hss.edu.
Jazyk: angličtina
Zdroj: Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons [Foot Ankle Surg] 2022 Aug; Vol. 28 (6), pp. 763-769. Date of Electronic Publication: 2021 Oct 12.
DOI: 10.1016/j.fas.2021.10.009
Abstrakt: Introduction: In hallux valgus (HV), first metatarsal pronation is increasingly recognized as an important aspect of the deformity. The purpose of this study was to compare pronation in HV patients determined from the shape of the lateral head of the first metatarsal on AP weightbearing radiographs with pronation calculated from weightbearing CT (WBCT) scans.
Methods: Patients were included in this study if they had preoperative and 5-month postoperative WBCT scans and corresponding weightbearing AP radiographs of the affected foot. Pronation of the first metatarsal on WBCT scans was measured using a 3D CAD model and the alpha angle and categorized into four groups on radiographs. Association between pronation groups on radiographs and WBCT scans was determined using Spearman correlation coefficients (r s ) and by comparing mean WBCT pronation of the first metatarsal between plain radiograph pronation groups.
Results: Agreement between the two observers' pronation on radiographs was good (k = 0.634) and moderate (k = 0.501), respectively. There was no correlation between radiographic pronation and the 3D CAD model (r s < 0.15). Preoperatively, there was weak correlation between the alpha angle and the radiographic pronation groups (r s = 0.371, P = 0.048) although this relationship did not hold postoperatively (r s = 0.330, P = 0.081). There was no difference in mean pronation calculated on WBCT scans between the plain radiographic groups.
Conclusion: Pronation of the first metatarsal measured on weightbearing AP radiographs had moderate interobserver agreement and was only weakly associated with pronation measured from WBCT scans. These results suggest that first metatarsal pronation measured on weightbearing radiographs is not a substitute for pronation measured on WBCT scans.
Level of Evidence: III, retrospective cohort study.
(Copyright © 2021 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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