Off-axis view radiographs for assessing hallux valgus interphalangeus in hallux valgus deformity: A comparison with the traditional anteroposterior standing radiographs |
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| Affiliation: | 1. Orthopedic and Foot Center Innsbruck, Innrain 2, 6020 Innsbruck, Austria;2. Department of Orthopedic Surgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria;3. Department of Medical Statistics, Informatics and Health Economics, Schöpfstraße 41/1, 6020 Innsbruck, Austria;1. Jagiellonian University, Faculty of Medicine, Department of Orthopaedics and Rehabilitation, Balzera 15, 34-500 Zakopane, Poland;2. Cracow University of Technology, Faculty of Mechanical Engineering, Institute of Applied Informatics, al. Jana Pawla II 37, 31-864 Krakow, Poland;3. Department of Orthopaedics, Paediatric Orthopaedics and Traumatology, Centre of Postgraduate Medical Education in Warsaw, Gruca Orthopaedic Hospital, Ks. Stanislawa Konarskiego 13, 05-400 Otwock, Poland;4. Department of Orthopaedics and Paediatric Orthopaedics, Medical University of Lodz, 251 Pomorska str, 92-213 Lodz, Poland;1. Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Puijonlaaksontie 2, 70210 Kuopio, Finland;2. Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio University Hospital, Yliopistoranta 1, 70210 Kuopio, Finland;1. Trauma and Orthopaedics Department, Sheffield Teaching Hospitals NHS Trust, Herries Rd, Sheffield S5 7AU, UK;2. Academic Unit of Bone Metabolism, The University of Sheffield, Sheffield S10 2RX, UK;3. Trauma and Orthopaedics Department, Warrington and Halton Hospitals NHS Foundation Trust, Lovely Ln, Warrington WA5 1QG, UK;4. Royal Berkshire Hospital, London Rd, Reading, RG1 5AN, UK;1. Hospital for Special Surgery, New York, NY 10021, USA;2. Seoul Foot and Ankle Center, Dubalo Orthopaedic Clinic, Seoul, Republic of Korea;3. Medical University of Vienna, 1090 Vienna, Austria;4. Georgetown University School of Medicine, Washington, DC, USA;1. Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran;2. Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran;3. Iranian Red Crescent Society, Rehabilitation Center of Esfahan, Esfahan, Iran |
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| Abstract: | BackgroundThe newly described anteroposterior “off-axis view” (OAV) radiograph might help detect a hallux valgus interphalangeus (HVI) deformity more precisely compared to anteroposterior standing radiographs.MethodsA radiographic assessment of HVI angles was performed using preoperative standing anteroposterior and OAV radiographs for 67 ft. Intra- and interobserver agreement for all angles and their correlation with HV severity were analyzed.ResultsThe proximal-to-distal phalangeal articular angle showed less intra- and interobserver variance (intraclass correlation coefficient: 0.825) than did the other angles. OAV radiographs showed less interobserver reliability than did standing radiographs. HVI was underestimated significantly, by up to 5°, on standing radiographs compared to OAV radiographs (p < 0.001). The mean differences between OAV and standing radiographs were 3.7° and 5.0° for the proximal-to-distal phalangeal articular and hallux interphalangeal angles, respectively, and were more pronounced for moderate-to-severe HV deformities.ConclusionAngular measurements of HVI on traditional anteroposterior standing radiographs are significantly smaller than on OAV radiographs. Furthermore, angular measurements on OAV radiographs are associated with higher interobserver reliability. The most precise angle representing an HVI deformity might be the proximal-to-distal phalangeal articular angle.Clinical RelevanceOur findings may facilitate preoperative decision-making for additional akin osteotomy in HV correction.Level of EvidenceLevel II. |
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| Keywords: | Hallux valgus Hallux valgus interphalangeus Reliability Radiological measurement Off-axis view |
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