Proximal to distal phalangeal articular angle of the first proximal phalanx: Reliability and correlation with round sign. Issue 8 (December 2022)
- Record Type:
- Journal Article
- Title:
- Proximal to distal phalangeal articular angle of the first proximal phalanx: Reliability and correlation with round sign. Issue 8 (December 2022)
- Main Title:
- Proximal to distal phalangeal articular angle of the first proximal phalanx: Reliability and correlation with round sign
- Authors:
- Lutz, Bernd
Kappe, Thomas
Reichel, Heiko
Taurman, Rita - Abstract:
- Abstract: Background: To reduce the rate of correction loss in hallux valgus surgery, a proximal to distal phalangeal articular angle (PDPAA) of the proximal phalanx of the greater toe of> 8° is considered an indication for a combined Akin and Chevron osteotomy. The PDPAA is measured between the articular surfaces of the proximal phalanx of the greater toe. Viewed from a sagittal perspective, the joint surfaces are not perpendicular aligned to the phalanx axis. Therefore, the PDPAA might be confounded by pronation. This study aims to, first, evaluate the intra- and interobserver reliability of the PDPAA and, second, to analyze the correlation to first ray pronation. Methods: In a consecutive series of 59 feet who underwent hallux valgus (HV) surgery, PDPAA, round sign and other angles were measured on weight-bearing radiographs pre- and postoperatively. After power analysis, the intraclass correlation coefficient (ICC) was used to calculate the intra- and interobserver reliability. The correlation of PDPAA with the round sign as well as angles defining the HV and the Hallux valgus interphalangeus (HVI) were evaluated. Results: The PDPAA showed an excellent intra- and interobserver reliability (ICC 0.92 and 0.89, p < 0.05). The round sign did not correlate significantly with the PDPAA (p = 0.51). However, the PDPAA showed a moderate correlation with the interphalangeal angle (r = 0.51, p < 0.05) and fair inversely with the intermetatarsal angle (r = −0.45, p < 0.05).Abstract: Background: To reduce the rate of correction loss in hallux valgus surgery, a proximal to distal phalangeal articular angle (PDPAA) of the proximal phalanx of the greater toe of> 8° is considered an indication for a combined Akin and Chevron osteotomy. The PDPAA is measured between the articular surfaces of the proximal phalanx of the greater toe. Viewed from a sagittal perspective, the joint surfaces are not perpendicular aligned to the phalanx axis. Therefore, the PDPAA might be confounded by pronation. This study aims to, first, evaluate the intra- and interobserver reliability of the PDPAA and, second, to analyze the correlation to first ray pronation. Methods: In a consecutive series of 59 feet who underwent hallux valgus (HV) surgery, PDPAA, round sign and other angles were measured on weight-bearing radiographs pre- and postoperatively. After power analysis, the intraclass correlation coefficient (ICC) was used to calculate the intra- and interobserver reliability. The correlation of PDPAA with the round sign as well as angles defining the HV and the Hallux valgus interphalangeus (HVI) were evaluated. Results: The PDPAA showed an excellent intra- and interobserver reliability (ICC 0.92 and 0.89, p < 0.05). The round sign did not correlate significantly with the PDPAA (p = 0.51). However, the PDPAA showed a moderate correlation with the interphalangeal angle (r = 0.51, p < 0.05) and fair inversely with the intermetatarsal angle (r = −0.45, p < 0.05). Conclusion: First, measurement of PDPAA is reliable. Second, PDPAA is not associated with first ray pronation, but a false low PDPAA is geometrically possible. A high PDPAA correlates with a relevant HVI and inversely correlates with the HV like the HVI. Hence, first ray pronation should be treated first and a remaining PDPAA of> 8° after intraoperatively reevaluation separately. … (more)
- Is Part Of:
- Foot and ankle surgery. Volume 28:Issue 8(2022)
- Journal:
- Foot and ankle surgery
- Issue:
- Volume 28:Issue 8(2022)
- Issue Display:
- Volume 28, Issue 8 (2022)
- Year:
- 2022
- Volume:
- 28
- Issue:
- 8
- Issue Sort Value:
- 2022-0028-0008-0000
- Page Start:
- 1411
- Page End:
- 1414
- Publication Date:
- 2022-12
- Subjects:
- Hallux valgus -- First metatarsal pronation -- First ray pronation
Foot -- Surgery -- Periodicals
Ankle -- Surgery -- Periodicals
Ankle -- surgery -- Periodicals
Foot -- surgery -- Periodicals
Ankle -- Surgery
Foot -- Surgery
Periodicals
Electronic journals
617.58 - Journal URLs:
- http://www.sciencedirect.com/science/journal/12687731 ↗
http://www3.interscience.wiley.com/journal/119485132/home ↗
http://firstsearch.oclc.org ↗
http://firstsearch.oclc.org/journal=1268-7731;screen=info;ECOIP ↗
http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1460-9584 ↗
http://www.clinicalkey.com/dura/browse/journalIssue/12687731 ↗
http://www.clinicalkey.com.au/dura/browse/journalIssue/12687731 ↗
http://www.elsevier.com/journals ↗ - DOI:
- 10.1016/j.fas.2022.08.002 ↗
- Languages:
- English
- ISSNs:
- 1268-7731
- Deposit Type:
- Legaldeposit
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- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 3984.875000
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