Panchbhavi Vinod K, Trevino Saul
Dept. Orthopaedics, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0165, USA.
Foot Ankle Int. 2004 Oct;25(10):708-11. doi: 10.1177/107110070402501003.
The aim of this study was to determine if there are intraobserver and interobserver differences in reliability when measuring hallux valgus angles (HVA), 1-2 intermetatarsal angles (IMA), and distal metatarsal articular angles (DMAA) manually compared to computer-assisted means. Our hypothesis was that the measurements taken by computer-assisted methods of these three forefoot angles would be superior in consistency and accuracy compared to manual measurements.
Four examiners studied 20 weightbearing anteroposterior radiographs of patients with hallux valgus. Manual measurements were taken on photographic prints using a goniometer and a fine point pen. Computer-assisted measurements were taken on digitized images using computer software. Three sets of measurements by both of these methods were taken 1 week apart.
There was no statistically significant difference between digital and manual measurements for any of the three angles measured (p .05). However, the reliability of measurements within a range of 5 degrees for both methods was 70.6% for HVA, 84% for 1-2 IMA, and 59% for DMAA.
There were no significant differences in interobserver and intraobserver reliability in measuring 1-2 IMA and HVA, regardless of the method of measurement; however, there was a significant difference in interobserver reliability when measuring the DMAA either on computer or manually (p = <.05).
本研究的目的是确定与计算机辅助测量相比，手动测量拇外翻角（HVA）、第1-2跖骨间角（IMA）和远端跖骨关节角（DMAA）时观察者内和观察者间的可靠性差异。我们的假设是，与手动测量相比，这三种前足角度的计算机辅助测量方法在一致性和准确性方面更具优势。
四名检查者研究了20例拇外翻患者的负重前后位X线片。使用测角仪和细尖笔在照片打印件上进行手动测量。使用计算机软件在数字化图像上进行计算机辅助测量。这两种方法的三组测量均间隔1周进行。
所测量的三个角度中，任何一个角度的数字测量和手动测量之间均无统计学显著差异（p>0.05）。然而，两种方法在5度范围内测量的可靠性，HVA为70.6%，1-2 IMA为84%，DMAA为59%。
无论测量方法如何，在测量1-2 IMA和HVA时，观察者间和观察者内的可靠性均无显著差异；然而，在计算机上或手动测量DMAA时，观察者间的可靠性存在显著差异（p<0.05）。
