Wang Qiong, Tong Jin, Liang Jiabao, Ji Dongdong, Wang Zhe, Liang Jingqi, Zhao Hongmou
Foot and Ankle Surgery Department, Honghui Hospital, Xi'an Jiaotong University, No. 76 Nanguo Road, Xi'an, 710054, People's Republic of China.
School of Medicine, Translational Medical Sciences, University of Nottingham, Nottingham, NG7 2RD, UK.
J Orthop Surg Res. 2025 Sep 1;20(1):814. doi: 10.1186/s13018-025-06196-y.
Hallux valgus (HV) is a common deformity of the hallux, which affects the functional ability of patients and reduces their quality of life. The American Orthopaedic Foot and Ankle Society (AOFAS) Hallux Metatarsophalangeal (MTP)-Interphalangeal (IP) scale is a questionnaire widely used to comprehensively assess the condition of hallux deformities. The purpose of this study was to translate the AOFAS-MTP-IP scale into a Chinese version (AOFAS-MTP-IP-CV), conduct cross-cultural adaptation, and simultaneously evaluate its validity and reliability.
Translate the AOFAS-Hallux-MTP-IP-CV according to general guidelines and conduct cross-cultural adaptation for it. From November 2024 to June 2025, a total of 120 patients with HV deformity who could communicate in Chinese were included. They successfully completed the demographic questionnaire, the Manchester-Oxford Foot Questionnaire-Chinese version (MOXFQ-CV), and the EuroQoL Group's five‑dimension questionnaire (EQ‑5D). The reliability of AOFAS-Hallux-MTP-IP-CV was determined by internal consistency, inter-rater reliability, intra-rater reliability, and test-retest reliability. Two orthopedic surgeons were responsible for the collection of questionnaires. The intra-rater reliability and inter-rater reliability were evaluated by the intraclass correlation coefficient (ICC). The internal consistency of the scale items was assessed by calculating the Cronbach's alpha coefficient. The Bland-Altman analysis was used to test the consistency between test-retest assessments. The construct validity of AOFAS-Hallux-MTP-IP-CV was determined by MOXFQ-CV and EQ-5D. Floor/ceiling effects were analyzed to assess scale responsiveness, with < 15% of scores at floor/ceiling levels indicating adequate range.
The AOFAS-Hallux-MTP-IP-CV was well accepted with no ceiling or floor effect. The intra-rater reliabilities of the total score of the AOFAS-Hallux-MTP-IP-CV and the pain, function, and alignment dimensions were 0.941, 0.925, 0.945, and 0.922, respectively. The inter-rater reliabilities were 0.916, 0.877, 0.885, and 0.896, respectively. The Bland-Altman plots showed good consistency in test-retest measurements. The total score of AOFAS-Hallux-MTP-IP-CV showed moderate to strong correlations with the pain dimension (r = -0.676) and the walking/standing dimension (r = -0.757) of the MOXFQ and the EQ-5D (r = -0.601).
The AOFAS-Hallux-MTP-IP-CV has good feasibility, reliability and validity. It can be recommended for the comprehensive assessment of the clinical conditions of patients with hallux valgus (HV) deformity in Mainland China.
拇外翻（HV）是一种常见的拇趾畸形，会影响患者的功能能力并降低其生活质量。美国矫形足踝协会（AOFAS）拇趾跖趾关节（MTP）-趾间关节（IP）评分量表是一种广泛用于全面评估拇趾畸形状况的问卷。本研究的目的是将AOFAS-MTP-IP量表翻译成中文版（AOFAS-MTP-IP-CV），进行跨文化调适，并同时评估其有效性和可靠性。
按照通用指南翻译AOFAS-拇趾-MTP-IP-CV并对其进行跨文化调适。2024年11月至2025年6月，共纳入120名能用中文交流的HV畸形患者。他们成功完成了人口统计学问卷、中文版曼彻斯特-牛津足部问卷（MOXFQ-CV）和欧洲生活质量五维度问卷（EQ-5D）。AOFAS-拇趾-MTP-IP-CV的可靠性通过内部一致性、评分者间信度、评分者内信度和重测信度来确定。两名骨科医生负责问卷收集。评分者内信度和评分者间信度通过组内相关系数（ICC）进行评估。量表项目的内部一致性通过计算Cronbach's α系数进行评估。采用Bland-Altman分析检验重测评估之间的一致性。AOFAS-拇趾-MTP-IP-CV的结构效度通过MOXFQ-CV和EQ-5D来确定。分析地板效应/天花板效应以评估量表反应度，地板/天花板水平得分<15%表明范围足够。
AOFAS-拇趾-MTP-IP-CV被广泛接受，无天花板效应或地板效应。AOFAS-拇趾-MTP-IP-CV总分以及疼痛、功能和对线维度的评分者内信度分别为0.941、0.925、0.945和0.922。评分者间信度分别为0.916、0.877、0.885和0.896。Bland-Altman图显示重测测量具有良好的一致性。AOFAS-拇趾-MTP-IP-CV总分与MOXFQ的疼痛维度（r = -0.676）、行走/站立维度（r = -0.757）以及EQ-5D（r = -0.601）呈中度至强相关。
AOFAS-拇趾-MTP-IP-CV具有良好的可行性、可靠性和有效性。可推荐用于中国大陆拇外翻（HV）畸形患者临床状况的综合评估。
