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Reliability and Relationship of Radiographic Measurements in Hallux Valgus

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Although various radiographic measurements have been developed and used for evaluating hallux valgus, not all are universally believed to be necessary and their relationships have not been clearly established. Determining which are related could provide some insight into which might be useful and which would not.

Questions/Purposes

We investigated the reliability of eight radiographic measurements used to evaluate hallux valgus, and determined which were correlated and which predicted the hallux valgus angle.

Methods

We determined eight radiographic indices for 732 patients (mean age, 51 years; SD, 17 years; 107 males and 625 females) with hallux valgus: hallux valgus angle, intermetatarsal angle, hallux interphalangeal angle, distal metatarsal articular angle, proximal phalangeal articular angle, simplified metatarsus adductus angle, first metatarsal protrusion distance, and sesamoid rotation angle. Intraobserver and interobserver reliabilities of each radiographic measurement were analyzed on 36 feet from 36 randomly selected patients. Correlations among the radiographic measurements were analyzed. Radiographic measurements predicting hallux valgus angle were evaluated using multiple regression analysis.

Results

Hallux valgus angle had the highest reliability, whereas the distal metatarsal articular angle and simplified metatarsus adductus angle had the lowest. Distal metatarsal articular angle, intermetatarsal angle, and sesamoid rotation angle had the highest correlations with hallux valgus angle. Distal metatarsal articular angle correlated with sesamoid rotation angle. The intermetatarsal angle, interphalangeal angle, distal metatarsal articular angle, first metatarsal protrusion distance, sesamoid rotation angle, and metatarsus adductus angle predicted the hallux valgus angle.

Conclusions

We suggest using hallux valgus angle, intermetatarsal angle, interphalangeal angle, sesamoid rotation angle, and first metatarsal protrusion distance considering their reliability and prediction of the deformity.

Level of Evidence

Level II, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Mi Sun Ryu BS, Jaebong Lee MS, Tae Won Kim MD, and Young Jin Park MD, for data management, statistical support, and advice.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-Gu, Sungnam, Kyungki, 463-707, Korea

    Kyoung Min Lee MD, Chin Youb Chung MD, Ki Hyuk Sung MD & Moon Seok Park MD

  2. Medical Research Collaboration Center, Seoul National University Bundang Hospital, Kyungki, Korea

    Soyeon Ahn PhD

Authors
  1. Kyoung Min Lee MD
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  2. Soyeon Ahn PhD
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  3. Chin Youb Chung MD
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  4. Ki Hyuk Sung MD
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  5. Moon Seok Park MD
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Corresponding author

Correspondence to Moon Seok Park MD.

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Each author certifies that he or she, or a member of their immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation was waived by the ethical committee due to the retrospective nature of the study.

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Lee, K.M., Ahn, S., Chung, C.Y. et al. Reliability and Relationship of Radiographic Measurements in Hallux Valgus. Clin Orthop Relat Res 470, 2613–2621 (2012). https://doi.org/10.1007/s11999-012-2368-6

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  • DOI: https://doi.org/10.1007/s11999-012-2368-6

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