La evaluación pre-operativo radiográfica en la deformacion del pulgar.(Inglés)

"La evaluación pre-operativo radiográfica en la deformacion del pulgar del pie: es seguro?".

A. S. Aster, , a, M. C. Forsterb, R. A. Rajanb, K. J. Patela, R. Asirvathama and C. Gilliesc

a Lincoln County Hospital, Lincoln LN2 5QY, UK b Leicester Royal Infirmary, Infirmary Square, Leicester L1 5WW, UK c Department of Epidemiology and Public Health, 22-28, Princes Road West, Leicester University, Leicester LE1 6TP, UK

Abstract

Objective:
The aim of this study was to assess the inter- and intra-observer reliability of the measurement of intermetatarsal angle (IMA), hallux valgus angle (HVA) and the diagnosis of joint congruency of the first metatarsophalangeal (MTP) joint.

Method:
Five observers assessed 50 pre-operative standing foot radiographs on two occasions. Five published methods of measuring IMA and HVA were used. Also the first MTP joint congruency was assessed.

Results:
The mean IMA and HVA measurements varied between methods on both occasions (P<0.0001). Analysis of variance showed both method and observer variations were significant for IMA, but not for HVA. Diagnosis of congruency showed good agreement (k=0.608) over two occasions, although this did vary by observer.

Conclusion:
Overall, there was no particular advantage to any measuring method. The reliability of IMA and HVA measurements are poor whichever measuring method is used and this limits the effectiveness of these radiographic findings for operation selection in hallux valgus.