TY - JOUR
T1 - How reliable are standard radiographic measures of the foot and ankle in children with achondroplasia?
AU - Xu, Jia
AU - Park, Kwang Won
AU - Kang, Qing Lin
AU - Jung, Young Jin
AU - Song, Hae Ryong
N1 - Funding Information:
The institution of one of the authors (H-RS) has received funding from the Korea Healthcare Technology R & D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A110416). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Each author certifies that his institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. This work was performed at the Institute for Rare Diseases Department of Orthopaedic Surgery, Korea University Medical College, Guro Hospital, Seoul, Korea.
PY - 2013/9
Y1 - 2013/9
N2 - Background: Radiographic measurements are typically used in achondroplasia (ACH) during correction of lower limb alignment. However, reliabilities for the measurements on weightbearing radiographs of the foot and ankle in patients with ACH have not been described, and the differences between the ACH population and subjects without ACH likewise have not been well characterized; these issues limit the use of studies on this subject. Questions/purposes: We proposed (1) to measure the inter- and intraobserver reliability of a number of radiographic measures of ankle and foot alignment in an achondroplastic cohort of patients; and (2) to compare our radiographic measurement values with age-matched literature-based normative values. Methods: Ten radiographic measurements were applied to foot and ankle radiographs of 20 children (40 feet) with ACH (mean age, 10 years; range, 8-16 years). Interobserver and intraobserver reliabilities of these radiographic measurement methods were obtained and expressed by intraclass correlation coefficients (ICCs). The mean values were calculated and compared with the literature-based values. Results: The interobserver reliability was excellent for eight measurements with ICCs ranging from 0.801 to 0.962, except for lateral talo-first metatarsal angle and mediolateral column ratio, which were much lower. The intraobserver reliability was excellent for all 10 radiographic measurements with ICCs ranging from 0.812 to 0.998. Compared with existing literature-based values, all 10 measurements had a significant difference (p < 0.01). Conclusions: We suggest tibiotalar angle, calcaneal pitch angle, tibiocalcaneal angle, talocalcaneal angle, naviculocuboid overlap, talonavicular coverage angle, metatarsal stacking angle, and AP talo-first metatarsal angle with excellent interobserver and intraobserver reliabilities should be considered preferentially in analysis of foot and ankle alignment in children with ACH. Level of Evidence: Level II, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
AB - Background: Radiographic measurements are typically used in achondroplasia (ACH) during correction of lower limb alignment. However, reliabilities for the measurements on weightbearing radiographs of the foot and ankle in patients with ACH have not been described, and the differences between the ACH population and subjects without ACH likewise have not been well characterized; these issues limit the use of studies on this subject. Questions/purposes: We proposed (1) to measure the inter- and intraobserver reliability of a number of radiographic measures of ankle and foot alignment in an achondroplastic cohort of patients; and (2) to compare our radiographic measurement values with age-matched literature-based normative values. Methods: Ten radiographic measurements were applied to foot and ankle radiographs of 20 children (40 feet) with ACH (mean age, 10 years; range, 8-16 years). Interobserver and intraobserver reliabilities of these radiographic measurement methods were obtained and expressed by intraclass correlation coefficients (ICCs). The mean values were calculated and compared with the literature-based values. Results: The interobserver reliability was excellent for eight measurements with ICCs ranging from 0.801 to 0.962, except for lateral talo-first metatarsal angle and mediolateral column ratio, which were much lower. The intraobserver reliability was excellent for all 10 radiographic measurements with ICCs ranging from 0.812 to 0.998. Compared with existing literature-based values, all 10 measurements had a significant difference (p < 0.01). Conclusions: We suggest tibiotalar angle, calcaneal pitch angle, tibiocalcaneal angle, talocalcaneal angle, naviculocuboid overlap, talonavicular coverage angle, metatarsal stacking angle, and AP talo-first metatarsal angle with excellent interobserver and intraobserver reliabilities should be considered preferentially in analysis of foot and ankle alignment in children with ACH. Level of Evidence: Level II, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
UR - http://www.scopus.com/inward/record.url?scp=84881670576&partnerID=8YFLogxK
U2 - 10.1007/s11999-013-3003-x
DO - 10.1007/s11999-013-3003-x
M3 - Article
C2 - 23609814
AN - SCOPUS:84881670576
SN - 0009-921X
VL - 471
SP - 3021
EP - 3028
JO - Clinical Orthopaedics and Related Research
JF - Clinical Orthopaedics and Related Research
IS - 9
ER -