Intra- and inter-observer reliability of the AFCP classification for sagittal plane deformities of the second toe

Lintz, François; Beldame, Julien; Kerhousse, G.; Bernasconi, Alessio; Brunel, Héléna; Darcel, Véronique; Hélix-Giordanino, M; Piclet-Legré, Barbara

doi:10.1016/j.fas.2019.08.011

Cited by 12 publications

(2 citation statements)

References 13 publications

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“…Nevertheless, if classifications for dissimilar diseases are considered, resemblance with the Sander classification (0.58) and with toe deformities staging (0.61) may be noted. 7,27,43 Intraobserver reliability was found to be very good, with a Cohen kappa of 0.851 (P < .001, 95% CI 0.777-0.926) sustaining the applicability of the classification in surgeons' daily practice. When contemplating classes individually, different reliabilities could be demonstrated, portraying interesting scenarios.…”

Section: Discussionmentioning

confidence: 74%

Intra- and Interobserver Reliability of the New Classification System of Progressive Collapsing Foot Deformity

et al. 2021

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Background: Historical concept of flatfoot as posterior tibial tendon dysfunction (PTTD) has been questioned. Recently, the consensus group published a new classification system and recommended renaming PTTD to Progressive Collapsing Foot Deformity (PCFD). The new PCFD classification could be effective in providing comprehensive information on the deformity. To date, there has been no study reporting intra- and interobserver reliability and the frequency of each class in PCFD classification. Methods: This was a single-center, retrospective study conducted from prospectively collected registry data. A consecutive cohort of PCFD patients evaluated from February 2015 to October 2020 was included, consisting of 92 feet in 84 patients. Classification of each patient was made using characteristic clinical and radiographic findings by 3 independent observers. Frequencies of each class and subclass were assessed. Intraobserver and inteobserver reliabilities were analyzed with Cohen kappa and Fleiss kappa, respectively. Results: Mean sample age was 54.4, 38% was male and 62% were female. 1ABC (25.4%) was the most common subclass, followed by 1AC (8.7%) and 1ABCD (6.9%). Only a small percentage of patients had isolated deformity. Class A was the most frequent component (89.5%), followed by C in 86.2% of the cases. Moderate interobserver reliability (Fleiss kappa = 0.561, P < .001, 95% CI 0.528-0.594) was found for overall classification. Very good intraobserver reliability was found (Cohen kappa = 0.851, P < .001, 95% CI 0.777-0.926). Conclusion: Almost half (49.3%) of patients had a presentation dominantly involving the hindfoot (A) with various combinations of midfoot and/or forefoot deformity (B), (C) with or without subtalar joint involvement (D). The new system may cover all possible combinations of the PCFD, providing a comprehensive description and guiding treatment in a systematic and individualized manner, but this initial study suggests an opportunity to improve overall interobserver reliability. Level of Evidence: Level III, retrospective diagnostic study.

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Section: Discussionmentioning

confidence: 74%

Intra- and Interobserver Reliability of the New Classification System of Progressive Collapsing Foot Deformity

et al. 2021

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“…Lesser toe deformities (LTD) and metatarsalgia are prevalent and challenging conditions that affect up to 60% of the adult population [1][2][3][4]. Associated pain and footwearrelated problems frequently lead symptomatic patients to seek medical attention [5].…”

Section: Introductionmentioning

confidence: 99%

Flexor tenodesis procedure in the treatment of lesser toe deformities

Schmidt

Lalevée

Mansur

2021

Arch Orthop Trauma Surg

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In this technical report study, we describe the use of a flexor tenodesis procedure in the treatment of lesser toe deformities (LTD). Using a specific implant, both the flexor digitorum longus and brevis tendons are attached to the plantar aspect of the proximal phalanx, allowing dynamic correction of flexible deformities of metatarsophalangeal and interphalangeal joints. Good clinical results and absence of complications were observed in a series of 3 patients, with considerable correction of the LTD, and absence of substantial residual floating toe or metatarsophalangeal joint stiffness. Level of evidence V – Technical Report/Case Report/Expert Opinion.

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Deformity of the Lesser Toes

Sotelano

Villena

2022

Foot and Ankle Disorders

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Intra- and inter-observer reliability of the AFCP classification for sagittal plane deformities of the second toe

Cited by 12 publications

References 13 publications

Intra- and Interobserver Reliability of the New Classification System of Progressive Collapsing Foot Deformity

Intra- and Interobserver Reliability of the New Classification System of Progressive Collapsing Foot Deformity

Flexor tenodesis procedure in the treatment of lesser toe deformities

Deformity of the Lesser Toes

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