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12.08.2021 | Original Paper

Correlation between indirect radiographic parameters of first metatarsal rotation in hallux valgus and values on weight-bearing computed tomography

verfasst von: Nacime Salomão Barbachan Mansur, Matthieu Lalevee, Eli Schmidt, Kevin Dibbern, Pablo Wagner, Emilio Wagner, Caio Augusto de Souza Nery, Cesar de Cesar Netto

Erschienen in: International Orthopaedics | Ausgabe 12/2021

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Abstract

Purpose

To verify if indirect radiographic signs of first metatarsal pronation, determined by the head round sign, correspond to weight-bearing computed tomography (WBCT) measurements.

Methods

In this case–control retrospective study, we analyzed 26 hallux valgus (HV) feet and 20 controls through conventional radiograph (CR) and WBCT images. Two blinded orthopaedic foot and ankle surgeons performed the measurements. Pronation classification (head roundness), head diameter (HD), traditional HV angles, arthritis, sesamoid positioning, and first metatarsal rotation angle (MRA) (alpha angle) were evaluated. Comparisons were performed by Student’s T-test and a multivariate regression was executed. P-values less than 0.05 were considered significant.

Results

Mean values were higher in HV patients than controls when evaluating MRA (11.51 [9.42–13.60] to 4.23 [1.84–6.62], 95%CI), HD (22.35 [21.52–23.18] to 21.01 [20.07–21.96]), and sesamoid rotation angle (SRA) (26.72 [24.09–29.34] to 4.56 [1.63–7.50]). The MRA had a low influence in head roundness classification (R²: 0.15). Changes in the pronation classification were explained chiefly by the sesamoid station (SS) (R²: 0.37), where stations 4 to 7 were found to be strong predictors of roundness classifications 2 and 3.

Conclusion

Indirect signs of metatarsal pronation, determined by the head round sign, correlate weakly with the alpha angle measured in WBCT. The presence of arthritis and sesamoids displacement might modify the perception of first head roundness. The influence of MRA in the classification was low, where SS from 4 to 7 was strong predictors of a higher pronation classification.

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Titel: Correlation between indirect radiographic parameters of first metatarsal rotation in hallux valgus and values on weight-bearing computed tomography
verfasst von: Nacime Salomão Barbachan Mansur
Matthieu Lalevee
Eli Schmidt
Kevin Dibbern
Pablo Wagner
Emilio Wagner
Caio Augusto de Souza Nery
Cesar de Cesar Netto
Publikationsdatum: 12.08.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 12/2021
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-021-05136-9

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Correlation between indirect radiographic parameters of first metatarsal rotation in hallux valgus and values on weight-bearing computed tomography