Reliability of the Radiographic Measurement of the Hallux Interphalangeal Angle

Abstract

Background The hallux valgus interphalangeus (HVI) deformity has a common association with hallux valgus and hallux rigidus. The HVI is formed by the angle between the long axes of the proximal and distal phalanges. The normal value for this angular deformity in the coronal plane is less than 10°. The aim of this study was to analyze the intra- and inter-observer reliability of measuring the interphalangeal angle by orthopaedic surgeons. This study is the first study to evaluate specifically the reliability and reproducibility of measuring the HVI angle. Methods Twenty-one X-ray prints of weightbearing feet constituted a set. Sixteen qualified orthopaedic surgeons were asked to measure the HVI angle of all 21 X-ray images in the set. Three randomized sets were sent to each evaluator at 4-week intervals. After all 3 sets were measured, data were retrieved and statistically analyzed to determine the inter- and intraobserver variability and reliability in the measurement of the HVI angle. Reproducibility of the HVI measurement was assessed using 3 categories, which included the ability to measure the same angle 3 times and achieve: 3° or less, 5° or less, and more than 5° variation. Results The intraobserver reliability was found to be 5° or less in 85.2% of participants and the interobserver reliability was 81.2%. The researcher did not find significant correlation between the surgeons’ level of experience with regard to the reliability of measuring the HVI angle. Conclusion The inter- and intraobserver reliabilities of measuring the HVI angle is 81.2% and 85.2%, respectively. The level of experience of the surgeon does not improve this reliability. Levels of Evidence Level II

Minimally Invasive Chevron-Akin for Correction of Moderate and Severe Hallux Valgus Deformities: Clinical and Radiologic Outcomes With a Minimum 2-Year Follow-up

“…In our study, intraobserver and interobserver agreement and consistency for HVA, IMA, and IPA demonstrated excellent reliability, similar to the results found by Chi et al 13 for HVA and IMA, and to the results found by Khademi et al 32 for IPA. We found good intraobserver and interobserver reliability for DMAA, different from the results presented by Vittetoe et al, 68 who obtained excellent intraobserver reliability and poor interobserver reliability, and the results presented by Lalevée et al, 34 who obtained excellent intraobserver and interobserver reliability.…”

“…There is growing interest in the use of minimally invasive surgical techniques (MIS) for the treatment of hallux valgus (HV), with an increasing number of published studies including clinical series, radiologic validations, cadaveric studies, comparative studies, and technical reports on MIS techniques. 1,4,[8][9][10][15][16][17][18][19][20][21]23,[26][27][28][29][30][31][32][33][34][35][36][39][40][41][42][43]45,55,[59][60][61][62][63][64]66,70 Five recent systematic reviews concluded that MIS is a safe and reliable technique for hallux valgus correction. 6,11,28,44,65 Among the procedures to treat HV, the distal chevron metatarsal osteotomy was first described in 1962 and remains a widely accepted technique.…”

“…There is growing interest in the use of minimally invasive surgical techniques (MIS) for the treatment of hallux valgus (HV), with an increasing number of published studies including clinical series, radiologic validations, cadaveric studies, comparative studies, and technical reports on MIS techniques. 1,4,8-10,15-21,23,26-36,39-43,45,55,59-64,66,70 Five recent systematic reviews concluded that MIS is a safe and reliable technique for hallux valgus correction. 6,11,28,44,65…”