Intra- and Interobserver Agreement in Hallux Valgus Angle Measurements on Weightbearing and Non-Weightbearing Radiographs
| Autor: | Martine Wever-Korevaar, Bregje J.W. Thomassen, Pieter van der Woude, Stefan B. Keizer |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Metatarsophalangeal Joint medicine.medical_specialty Intraclass correlation Fleiss' kappa Weight-Bearing 03 medical and health sciences 0302 clinical medicine Medicine Humans Orthopedics and Sports Medicine Prospective Studies Hallux Valgus Metatarsal Bones Valgus deformity Aged Orthodontics Subluxation Aged 80 and over Observer Variation 030222 orthopedics biology business.industry Forefoot 030229 sport sciences Middle Aged medicine.disease biology.organism_classification Surgery Radiography Valgus medicine.anatomical_structure Orthopedic surgery Female Ankle business |
| Zdroj: | The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons. 58(4) |
| ISSN: | 1542-2224 |
| Popis: | The choice of treatment of hallux valgus deformity is influenced by angles measured on radiographs. Angles of interest are the hallux valgus angle (HVA), 1,2-intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA), as well as the presence of first metatarsophalangeal joint (MTPJ) subluxation. Guidelines for measuring those angles have been distributed by American Orthopaedic Foot and Ankle Society (AOFAS), although the influence of weightbearing on these angles and its clinical relevance is not clear. We conducted a study to determine the influence of weightbearing and the inter- and intraobserver agreement in the measurement. A total of 104 patients were enrolled in this study. Both weightbearing and non-weightbearing radiographs were obtained. In 2 rounds, 2 orthopedic surgeons and 2 musculoskeletal radiologists measured the angles in blinded digital radiographs according to AOFAS guidelines. Agreement on measurement of HVA, IMA, and DMAA in both weightbearing and non-weightbearing radiographs, as well as the presence of MTPJ subluxation, was calculated using the linear-weighted kappa coefficient and the intraclass correlation coefficient (ICC). Examiner agreement strength was defined according to the guidelines of Landis and Koch. HVA decreases significantly with weightbearing, whereas IMA significantly increases. The change in magnitude was 1° to 2° on average. No significant influence on DMAA could be noted. Interobserver agreement was excellent in both weightbearing and non-weightbearing radiographs for HVA (ICC 0.99 and ICC 0.99, respectively), IMA (ICC 0.98 and ICC 0.86, respectively), and DMAA (ICC 0.95 and ICC 0.97, respectively). The agreement on presence of subluxation was moderate to good (Fleiss kappa 0.50 to 0.63). Weightbearing alters forefoot geometry significantly. Adhering to AOFAS guidelines yields excellent interobserver agreement on HVA, IMA, and DMAA. First MTPJ subluxation presence is not an alternative for DMAA. The magnitude of change in IMA and HVA is small and therefore not clinically important. Both weightbearing and non-weightbearing radiographs can be used for determination of the correct treatment of hallux valgus deformity. |
| Databáze: | OpenAIRE |
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