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山口法评估拇外翻畸形中第一跖骨内旋的观察者内及观察者间可靠性

Intra‑ and Interobserver Reliability of Yamaguchi's Method for the Assessment of First Metatarsal Pronation in Hallux Valgus Deformity.

作者信息

Del Vecchio Jorge Javier, Dealbera Eric Daniel, Brue Julieta, Ghioldi Mauricio Esteban, Chemes Lucas Nicolás, Abdelatif Nasef M N, Chan Debora

机构信息

Head Foot and Ankle Section, Orthopaedics Department, Fundación Favaloro -Hospital Universitario, Buenos Aires, Argentina; Department of Kinesiology and Physiatry, Universidad Favaloro, Buenos Aires, Argentina; Minimally Invasive Foot and Ankle Society (GRECMIP-MIFAS), Merignac, France.

Foot and Ankle Section, Orthopaedics Department, Hospital Universitario - Fundación Favaloro, Buenos Aires, Argentine.

出版信息

J Foot Ankle Surg. 2023 May-Jun;62(3):432-436. doi: 10.1053/j.jfas.2022.10.008. Epub 2022 Oct 28.

Abstract

Pronation of the first metatarsal is a risk factor for the formation and progression of the hallux valgus deformity. Recently, Yamaguchi et al published a study that showed how the round sign increases on digitally reconstructed radiography taken from a CT scan when pronation is applied. In this study, the shape of the lateral edge of the first metatarsal head was evaluated on weightbearing dorsoplantar radiographs. Yamaguchi's signs were presented to observers after the visual presentation of each foot as an image. The best-fit circle was drawn using the PACS drawing function. Ninety radiographs of adults presenting hallux valgus deformities were classified as mild-to-moderate, based on hallux valgus angle and intermetatarsal angle. The global average observations were 3.72 ± 3.92 (range 2.3°-4.6°). The interclass correlation (Fleiss Kappa index κ = 0.225) and the Spearman correlation (0.16 of Kappa) coefficients were poor for interobserver measurements and statistically significant. Using the linear model, there was no significant variability between the repetitions corresponding to each observer (t-value -1.527, p value .127). Our findings show that the Yamaguchi method can be very subjective and should not be the exclusive technique to assess the rotation of the first metatarsal or head roundness.

摘要

第一跖骨内旋是拇外翻畸形形成和进展的一个危险因素。最近,山口等人发表了一项研究,该研究表明在施加内旋时,从CT扫描获取的数字重建X线片上圆形征是如何增加的。在本研究中,在负重背跖位X线片上评估第一跖骨头外侧边缘的形状。在将每只脚的图像视觉呈现给观察者后,向其展示山口征。使用PACS绘图功能绘制最佳拟合圆。根据拇外翻角和跖间角,将90张患有拇外翻畸形的成人X线片分类为轻度至中度。总体平均观察值为3.72±3.92(范围2.3°-4.6°)。观察者间测量的组内相关系数(Fleiss Kappa指数κ=0.225)和Spearman相关系数(Kappa值为0.16)较差,但具有统计学意义。使用线性模型,每个观察者对应的重复测量之间没有显著差异(t值为-1.527,p值为0.127)。我们的研究结果表明,山口法可能非常主观,不应作为评估第一跖骨旋转或头部圆度的唯一技术。

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