Menz H B, Munteanu S E
Musculoskeletal Research Centre, School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria 3086, Australia.
Rheumatology (Oxford). 2005 Aug;44(8):1061-6. doi: 10.1093/rheumatology/keh687. Epub 2005 May 18.
Hallux valgus is a common orthopaedic condition affecting elderly people. Grading the severity of the condition commonly involves obtaining measurements from radiographs, which may not be feasible or necessary in some clinical or research settings. Recently, a non-invasive clinical assessment tool (the Manchester scale), consisting of four standardized photographs, has been developed; however, its validity has not yet been determined. Therefore, the objective of this study was to determine the validity of this tool by correlating Manchester scale scores with hallux valgus measurements obtained from radiographs.
Weight-bearing dorsoplantar foot radiographs were obtained from 95 subjects (31 men and 64 women) aged 62-94 yr (mean 78.6, s.d. 6.5), and measurements of the hallux abductus angle, intermetatarsal angle and hallux interphalangeal adbuctus angle were performed. These measurements were then correlated with the Manchester scale scores (none, mild, moderate or severe).
The Manchester scale score was highly correlated with hallux abductus angle (Spearman's rho = 0.73, P<0.01) and moderately associated with intermetatarsal angle (rho = 0.49, P<0.01) measurements obtained from radiographs. Analysis of variance revealed significant differences in mean hallux abductus angles [F3 = 119.99, P<0.001] and intermetatarsal angles [F3 =29.56, P<0.001] between the four Manchester scale categories.
These findings indicate that the Manchester scale provides a valid representation of the degree of hallux valgus deformity determined from radiographic measurement of hallux abductus angle and intermetatarsal angle. We therefore recommend the use of this instrument as a simple, non-invasive screening tool for clinical and research purposes.
拇外翻是一种影响老年人的常见骨科病症。对该病症的严重程度进行分级通常需要从X光片中获取测量数据，但在某些临床或研究环境中这可能不可行或没有必要。最近，一种由四张标准化照片组成的非侵入性临床评估工具（曼彻斯特量表）已被开发出来；然而，其有效性尚未得到确定。因此，本研究的目的是通过将曼彻斯特量表评分与从X光片中获得的拇外翻测量数据相关联，来确定该工具的有效性。
对95名年龄在62 - 94岁（平均78.6岁，标准差6.5）的受试者（31名男性和64名女性）进行负重位足背跖侧X光片拍摄，并测量拇外展角、跖间角和拇趾间关节外展角。然后将这些测量数据与曼彻斯特量表评分（无、轻度、中度或重度）进行关联。
曼彻斯特量表评分与X光片中获得的拇外展角高度相关（斯皮尔曼等级相关系数ρ = 0.73，P < 0.01），与跖间角中度相关（ρ = 0.49，P < 0.01）。方差分析显示，在四个曼彻斯特量表类别之间，平均拇外展角[F3 = 119.99，P < 0.001]和跖间角[F3 = 29.56，P < 0.001]存在显著差异。
这些发现表明，曼彻斯特量表能够有效地反映通过X光片测量拇外展角和跖间角所确定的拇外翻畸形程度。因此，我们建议将该工具用作临床和研究目的的简单、非侵入性筛查工具。
