Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Department of Orthopedics and Traumatology, Escola Paulista de Medicina, UNIFESP, Sao Paulo, Sao Paulo, Brazil.
Foot Ankle Int. 2023 Feb;44(2):125-129. doi: 10.1177/10711007221141898. Epub 2023 Jan 13.
The objective of this study was to compare progressive collapsing foot deformity (PCFD) classifications performed using clinical and conventional radiographs (CR) with classifications established using clinical and weightbearing computed tomography (WBCT).
This retrospective comparative study evaluated 89 consecutive PCFD feet (84 patients). Three readers performed chart reviews and CR evaluations, determining PCFD classifications that were previously published. After a washout period, the sequence was randomized, and a new classification was executed using clinical and WBCT assessment. One of the readers repeated the WBCT evaluation for intrarater reliability.
Interrater reliability for the WBCT was found moderate (0.55) and intrarater excellent (0.98). Evaluation using WBCT produced 29.6% of 1ABC (CR: 25.4%, = .270), 11.6% of 1ABCD (CR: 6.9%, = .081), and 6.4% of BC (CR: 3.3%, = .090) as most prevalent. Class A was presented in 83.9% (CR: 89.5%, = .55), class B in 89.9% (CR: 76.4%, < .001), class C in 93.6% (CR: 86.2%, = .004), class D in 46.4% (CR: 34.8%, = .006), and class E in 27.7% (CR: 22.5%, = .158) of the classifications performed by WBCT.
WBCT showed a different rate of deformity recognition, which increased the incidence of all classes, especially B, C, and D. An excellent intrarater agreement was found, which infers assessment reliability combining clinical and WBCT evaluation. The obtained information could enhance disease understanding and supply patients with more precise care.
Level III, retrospective comparative study.
本研究旨在比较临床和常规放射学（CR）与临床和负重 CT（WBCT）建立的分类标准对进行性塌陷足畸形（PCFD）的分类。
本回顾性对比研究评估了 89 例连续的 PCFD 足（84 例患者）。三位读者进行了图表回顾和 CR 评估，确定了先前发表的 PCFD 分类。在洗脱期后，序列随机化，并使用临床和 WBCT 评估执行新的分类。其中一位读者重复了 WBCT 评估以进行组内可靠性。
WBCT 的组内可靠性为中度（0.55），组内可靠性为极好（0.98）。使用 WBCT 进行评估产生了 29.6%的 1ABC（CR：25.4%， =.270）、11.6%的 1ABCD（CR：6.9%， =.081）和 6.4%的 BC（CR：3.3%， =.090）作为最常见的分类。83.9%（CR：89.5%， =.55）表现为 A 类，89.9%（CR：76.4%，<.001）表现为 B 类，93.6%（CR：86.2%， =.004）表现为 C 类，46.4%（CR：34.8%，<.006）表现为 D 类，27.7%（CR：22.5%， =.158）表现为 E 类。
WBCT 显示出不同的畸形识别率，增加了所有类别的发生率，特别是 B、C 和 D 类。发现组内一致性极好，这表明结合临床和 WBCT 评估的评估可靠性。获得的信息可以增强对疾病的理解，并为患者提供更精确的护理。
三级，回顾性对比研究。
