Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지
DOI QR코드

DOI QR Code

Change of Reliability for Distal Metatarsal Articular Angle Measurement before and after Proximal Chevron Osteotomy

근위 갈매기 절골술 시행 전과 후의 원위 중족골 관절면각의 측정에 대한 신뢰성의 변화

  • Park, Chul Hyun (Department of Orthopedic Surgery, Yeungnam University College of Medicine) ;
  • Lee, Dong Yeol (Department of Orthopedic Surgery, Yeungnam University College of Medicine)
  • 박철현 (영남대학교 의과대학 정형외과학교실) ;
  • 이동열 (영남대학교 의과대학 정형외과학교실)
  • Received : 2016.07.21
  • Accepted : 2016.10.12
  • Published : 2016.12.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: To evaluate the reliability of preoperative and postoperative distal metatarsal articular angle (DMAA) measurements and to determine whether such reliability is different in accordance with the foot and ankle fellowship and the number of years in practice. Materials and Methods: Between July 2012 and June 2014, a total of 20 patients (24 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic hallux valgus deformity. DMAA were measured twice with an interval of two weeks between the preoperative and postoperative dorsoplantar radiographs by four observers; two of whom were foot and ankle surgeons (A and B), one knee surgeon, and one senior resident. The intraobserver reproducibility and interobserver reliability were assessed by intraclass correlation coefficients. Moreover, the limit of agreement between the preoperative and postoperative DMAA measurements were assessed using a Bland-Altman plot. Results: The intraobserver reproducibility of the foot and ankle surgeon A, knee surgeon, and senior resident improved from 0.796, 0.575, and 0.586 preoperatively to 0.968, 0.864, and 0.864 postoperatively, respectively. The interobserver reliability of foot and ankle surgeon A-B, foot and ankle surgeon A-knee surgeon, and foot and ankle surgeon A-senior resident improved from 0.874, 0.688, and 0.677 preoperatively to 0.971, 0.917, and 0.838 postoperatively, respectively. Conclusion: The intra- and interobserver reliabilities for DMAA measurement improved after proximal chevron osteotomy. Therefore, the necessity of additional procedures to correct the increased DMAA should be reevaluated after proximal chevron osteotomy in the hallux valgus with an increased DMAA.

Keywords

References

  1. Bonnel F, Canovas F, Poiree G, Dusserre F, Vergnes C. Evaluation of the scarf osteotomy in hallux valgus related to distal metatarsal articular angle: a prospective study of 79 operated cases. Rev Chir Orthop Reparatrice Appar Mot. 1999;85:381-6.
  2. Park CH, Cho JH, Moon JJ, Lee WC. Can double osteotomy be a solution for adult hallux valgus deformity with an increased distal metatarsal articular angle? J Foot Ankle Surg. 2016;55:188-92. https://doi.org/10.1053/j.jfas.2015.05.004
  3. Chi TD, Davitt J, Younger A, Holt S, Sangeorzan BJ. Intra- and inter-observer reliability of the distal metatarsal articular angle in adult hallux valgus. Foot Ankle Int. 2002;23:722-6. https://doi.org/10.1177/107110070202300808
  4. Coughlin MJ. Roger A. Mann Award. Juvenile hallux valgus: etiology and treatment. Foot Ankle Int. 1995;16:682-97. https://doi.org/10.1177/107110079501601104
  5. Okuda R, Kinoshita M, Yasuda T, Jotoku T, Kitano N, Shima H. Postoperative incomplete reduction of the sesamoids as a risk factor for recurrence of hallux valgus. J Bone Joint Surg Am. 2009;91:1637-45. https://doi.org/10.2106/JBJS.H.00796
  6. Lee KM, Ahn S, Chung CY, Sung KH, Park MS. Reliability and relationship of radiographic measurements in hallux valgus. Clin Orthop Relat Res. 2012;470:2613-21. https://doi.org/10.1007/s11999-012-2368-6
  7. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307-10.
  8. Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86:420-8. https://doi.org/10.1037/0033-2909.86.2.420
  9. Eustace S, O'Byrne J, Stack J, Stephens MM. Radiographic features that enable assessment of first metatarsal rotation: the role of pronation in hallux valgus. Skeletal Radiol. 1993;22:153-6.
  10. Coughlin MJ, Freund E. The reliability of angular measurements in hallux valgus deformities. Foot Ankle Int. 2001;22:369-79. https://doi.org/10.1177/107110070102200503
  11. Chou LB, Mann RA, Casillas MM. Biplanar chevron osteotomy. Foot Ankle Int. 1998;19:579-84. https://doi.org/10.1177/107110079801900902
  12. Corte-Real NM, Moreira RM. Modified biplanar chevron osteotomy. Foot Ankle Int. 2009;30:1149-53. https://doi.org/10.3113/FAI.2009.1149
  13. DeOrio J. Technique tip: dorsal wedge resection (uniplanar) in the chevron osteotomy for high distal metatarsal articular angle bunions. Foot Ankle Int. 2007;28:642-4. https://doi.org/10.3113/FAI.2007.0642
  14. Aronson J, Nguyen LL, Aronson EA. Early results of the modified peterson bunion procedure for adolescent hallux valgus. J Pediatr Orthop. 2001;21:65-9. https://doi.org/10.1097/01241398-200101000-00014
  15. Coughlin MJ, Carlson RE. Treatment of hallux valgus with an increased distal metatarsal articular angle: evaluation of double and triple first ray osteotomies. Foot Ankle Int. 1999;20:762-70. https://doi.org/10.1177/107110079902001202
  16. Johnson AE, Georgopoulos G, Erickson MA, Eilert R. Treatment of adolescent hallux valgus with the first metatarsal double osteotomy: the denver experience. J Pediatr Orthop. 2004;24:358-62. https://doi.org/10.1097/01241398-200407000-00003
  17. Yasuda T, Okuda R, Jotoku T, Shima H, Hida T, Neo M. Proximal supination osteotomy of the first metatarsal for hallux valgus. Foot Ankle Int. 2015;36:696-704. https://doi.org/10.1177/1071100715572188
  18. Scott G, Wilson DW, Bentley G. Roentgenographic assessment in hallux valgus. Clin Orthop Relat Res. 1991;(267):143-7.
  19. Shereff MJ, DiGiovanni L, Bejjani FJ, Hersh A, Kummer FJ. A comparison of nonweight-bearing and weight-bearing radiographs of the foot. Foot Ankle. 1990;10:306-11. https://doi.org/10.1177/107110079001000604
  20. Tanaka Y, Takakura Y, Takaoka T, Akiyama K, Fujii T, Tamai S. Radiographic analysis of hallux valgus in women on weightbearing and nonweightbearing. Clin Orthop Relat Res. 1997;(336):186-94.
  21. Robinson AH, Cullen NP, Chhaya NC, Sri-Ram K, Lynch A. Variation of the distal metatarsal articular angle with axial rotation and inclination of the first metatarsal. Foot Ankle Int. 2006;27:1036-40. https://doi.org/10.1177/107110070602701207
  22. Vittetoe DA, Saltzman CL, Krieg JC, Brown TD. Validity and reliability of the first distal metatarsal articular angle. Foot Ankle Int. 1994;15:541-7. https://doi.org/10.1177/107110079401501004

Cited by

  1. 변형 Scarf 및 Akin 절골술 후 무지외반변형 재발의 방사선학적 위험인자 연구 vol.23, pp.4, 2016, https://doi.org/10.14193/jkfas.2019.23.4.159