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The inter- and intraobserver reliability for the radiological parameters of flatfoot, before and after surgery.

Abstract Aims Various radiological parameters are used to evaluate a flatfoot deformity and their measurements may differ. The aims of this study were to answer the following questions: 1) Which of the 11 parameters have the best inter- and intraobserver reliability in a standardized radiological setting? 2) Are pre- and postoperative assessments equally reliable? 3) What are the identifiable sources of variation? Patients and Methods Measurements of the 11 parameters were recorded on anteroposterior and lateral weight-bearing radiographs of 38 feet before and after surgery for flatfoot, by three observers with different experience in foot surgery (A, ten years; B, three years; C, third-year orthopaedic resident). The inter- and intraobserver reliability was calculated. Results Preoperative interobserver reliability was high for four, moderate for five, and low for two parameters. Postoperative interobserver reliability was high for four, moderate for five, and low for two parameters. Intraobserver reliability was excellent for all parameters preoperatively as recorded by observer A (PB) and B (MP), and for eight parameters as recorded by observer C (SR). Intraobserver reliability was excellent for ten parameters postoperatively as recorded by observer A and B, and for eight parameters as recorded by observer C. Conclusion The following parameters can be recommended. For preoperative and postoperative evaluation of flatfoot: anteroposterior, talonavicular coverage angle; lateral, talometatarsal I angle, calcaneal pitch angle, and cuneiform-medial height (high interobserver reliability); and anteroposterior, talometatarsal II angle; lateral, talocalcaneal angle,tibiocalcaneal angle (moderate interobserver reliability). For more experienced observers, we also recommend the anteroposterior talometatarsal I angle (moderate reliability). The inter- and intraobserver reliability for most parameters were similar pre- and postoperatively. The experience of the observer and the definition and ability to measure the parameters themselves were sources of variation. Cite this article: Bone Joint J 2018;100-B:596-602.
PMID
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Inter- and intraobserver reliability in the radiographic evaluation of adult flatfoot deformity.

Authors

Mayor MeshTerms
Keywords

Flatfoot

Radiograph

Radiologic parameters

X-ray

Journal Title the bone & joint journal
Publication Year Start




PMID- 29701104
OWN - NLM
STAT- MEDLINE
DCOM- 20180516
LR  - 20180516
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 100-B
IP  - 5
DP  - 2018 May 1
TI  - The inter- and intraobserver reliability for the radiological parameters of
      flatfoot, before and after surgery.
PG  - 596-602
LID - 10.1302/0301-620X.100B5.BJJ-2017-1279 [doi]
AB  - Aims Various radiological parameters are used to evaluate a flatfoot deformity
      and their measurements may differ. The aims of this study were to answer the
      following questions: 1) Which of the 11 parameters have the best inter- and
      intraobserver reliability in a standardized radiological setting? 2) Are pre- and
      postoperative assessments equally reliable? 3) What are the identifiable sources 
      of variation? Patients and Methods Measurements of the 11 parameters were
      recorded on anteroposterior and lateral weight-bearing radiographs of 38 feet
      before and after surgery for flatfoot, by three observers with different
      experience in foot surgery (A, ten years; B, three years; C, third-year
      orthopaedic resident). The inter- and intraobserver reliability was calculated.
      Results Preoperative interobserver reliability was high for four, moderate for
      five, and low for two parameters. Postoperative interobserver reliability was
      high for four, moderate for five, and low for two parameters. Intraobserver
      reliability was excellent for all parameters preoperatively as recorded by
      observer A (PB) and B (MP), and for eight parameters as recorded by observer C
      (SR). Intraobserver reliability was excellent for ten parameters postoperatively 
      as recorded by observer A and B, and for eight parameters as recorded by observer
      C. Conclusion The following parameters can be recommended. For preoperative and
      postoperative evaluation of flatfoot: anteroposterior, talonavicular coverage
      angle; lateral, talometatarsal I angle, calcaneal pitch angle, and
      cuneiform-medial height (high interobserver reliability); and anteroposterior,
      talometatarsal II angle; lateral, talocalcaneal angle,tibiocalcaneal angle
      (moderate interobserver reliability). For more experienced observers, we also
      recommend the anteroposterior talometatarsal I angle (moderate reliability). The 
      inter- and intraobserver reliability for most parameters were similar pre- and
      postoperatively. The experience of the observer and the definition and ability to
      measure the parameters themselves were sources of variation. Cite this article:
      Bone Joint J 2018;100-B:596-602.
FAU - Bock, P
AU  - Bock P
AD  - Orthopaedic Hospital Speising, Vienna, Austria.
FAU - Pittermann, M
AU  - Pittermann M
AD  - Danube Hospital Wien, Vienna, Austria.
FAU - Chraim, M
AU  - Chraim M
AD  - Orthopaedic Hospital Wien Speising, Vienna, Austria.
FAU - Rois, S
AU  - Rois S
AD  - Landes-Krankenhaus Freistadt, Freistadt, Austria.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - AIM
SB  - IM
MH  - Body Weights and Measures
MH  - Flatfoot/*diagnostic imaging/*surgery
MH  - Foot/*diagnostic imaging/surgery
MH  - Humans
MH  - Observer Variation
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Tarsal Bones/*diagnostic imaging/surgery
OTO - NOTNLM
OT  - Flatfoot
OT  - Radiograph
OT  - Radiologic parameters
OT  - X-ray
EDAT- 2018/04/28 06:00
MHDA- 2018/05/17 06:00
CRDT- 2018/04/28 06:00
PHST- 2018/04/28 06:00 [entrez]
PHST- 2018/04/28 06:00 [pubmed]
PHST- 2018/05/17 06:00 [medline]
AID - 10.1302/0301-620X.100B5.BJJ-2017-1279 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 May 1;100-B(5):596-602. doi:
      10.1302/0301-620X.100B5.BJJ-2017-1279.