Jastifer James R, Coughlin Michael J, Schutt Shane, Hirose Christopher, Kennedy Michael, Grebing Brett, Smith Bertil, Cooper Truitt, Golano Pau, Viladot Ramon, Doty Jesse F
Saint Alphonsus Coughlin Foot & Ankle Clinic, Boise, Idaho.
Foot Ankle Int. 2014 Apr;35(4):389-93. doi: 10.1177/1071100714522027. Epub 2014 Feb 12.
A few studies report correlations between radiographic and anatomic measurements of the distal metatarsal articular angle (DMAA). However, little is known about how the DMAA correlates with the hallux valgus angle (HVA) and with anatomic and clinical radiographic measurements.
We dissected, measured, and radiographed 39 cadaveric feet for evidence of hallux valgus and the DMAA. We then correlated these values with paired clinical radiographic measurements made by physician evaluators.
Physician measurement of DMAA and anatomic measurement of DMAA were significantly correlated with a mean r = 0.64 (evaluator range, 0.44-0.66). Pairwise correlation between physician evaluators ranged from r = 0.63 to 0.84. Sixty-six percent of physician-measured DMAAs were within 5 degrees of anatomic DMAA.
The percentage of radiographic DMAAs that were within 5 degrees of anatomic DMAAs was only 66%. Additionally, the DMAA was increased in the specimens with moderate and severe hallux valgus compared with those with normal or mild hallux valgus angles.
The DMAA is an important consideration in patients with hallux valgus. While it is less reliable than other radiographic measures, it was correlated to deformity severity in specimen with hallux valgus.
少数研究报告了跖骨远端关节角（DMAA）的影像学测量与解剖学测量之间的相关性。然而，关于DMAA如何与拇外翻角（HVA）以及解剖学和临床影像学测量相关，人们知之甚少。
我们对39具尸体足进行了解剖、测量和影像学检查，以寻找拇外翻和DMAA的证据。然后我们将这些值与医生评估者进行的配对临床影像学测量结果进行关联。
医生对DMAA的测量与DMAA的解剖学测量显著相关，平均r = 0.64（评估者范围为0.44 - 0.66）。医生评估者之间的成对相关性范围为r = 0.63至0.84。66%的医生测量的DMAA在解剖学DMAA的5度范围内。
影像学DMAA在解剖学DMAA的5度范围内的比例仅为66%。此外，与拇外翻角度正常或轻度的标本相比，中度和重度拇外翻标本中的DMAA有所增加。
DMAA是拇外翻患者的一个重要考虑因素。虽然它比其他影像学测量方法的可靠性低，但它与拇外翻标本的畸形严重程度相关。
