Implementation and Validation of Anatomic Triplane Hallux Abducto Valgus Classification
Category: Bunion Introduction/Purpose: The most common classification system for HAV deformity is based on two-dimensional radiographs. This system relies upon measurements taken of the transverse plane. (IMA and HVA) to classify and deploy surgical options based on the severity of these angles [1]....
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2017-09-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011417S000355 |
| _version_ | 1818922949314347008 |
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| author | Robert Santrock MD W. Bret Smith MSc, DO Paul Dayton MS, DPM Daniel Hatch FACFAS |
| author_facet | Robert Santrock MD W. Bret Smith MSc, DO Paul Dayton MS, DPM Daniel Hatch FACFAS |
| author_sort | Robert Santrock MD |
| collection | DOAJ |
| description | Category: Bunion Introduction/Purpose: The most common classification system for HAV deformity is based on two-dimensional radiographs. This system relies upon measurements taken of the transverse plane. (IMA and HVA) to classify and deploy surgical options based on the severity of these angles [1]. Recently, the understanding of HAV deformity as a three-dimensional problem has been described. A study by Kim et al. [2] utilized WB-CT to describe a frontal plane rotational component in 87% HAV cases. To develop a better understanding of HAV, a unique anatomic classification system (see figure) was proposed. The aims of this study were: (1) To use traditional WB radiographs to confirm the findings of Kim’s WB-CT study. (2)To use inter-observer and intra-observer analysis to validate the classification of HAV into this new system. Methods: An Institutional Review Board approved multi-center retrospective study was performed utilizing four view WB radiographs (Anterior-Posterior, Oblique, Lateral and Axial Sesamoid) on patients presenting to the clinic for “bunion,” Hallux Valgus, HAV, Hallux Rigidus or “great toe pain.” The data were analyzed for the presence of frontal/coronal plane rotation of the first metatarsal, subluxation of the sesamoids, metatarsus adductus and degenerative joint disease of the first MTP (metatarsophalangeal) joint (Hallux Rigidus); these findings were compared to Kim’s study. Additionally, these data were used to categorize HAV deformities into a new 3D classification scheme and were tested for inter-observer and intra-observer reliability. Results: The results established the presence of frontal/coronal plane rotation and subluxation in similar ratios as reported by Kim et al. thus confirming the utility of a four-view WB radiograph series in recognition of 3D deformity of HAV. The results also confirmed good reliability of the classification from both the inter-observer and intra-observer standpoint. Conclusion: These data suggest that new protocols and tools are reliable in helping the surgeon recognize and better identify the three-dimensional components of HAV. |
| first_indexed | 2024-12-20T02:01:40Z |
| format | Article |
| id | doaj.art-a5beec22dfaf483a910f35c97182d7fd |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-12-20T02:01:40Z |
| publishDate | 2017-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-a5beec22dfaf483a910f35c97182d7fd2022-12-21T19:57:19ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142017-09-01210.1177/2473011417S000355Implementation and Validation of Anatomic Triplane Hallux Abducto Valgus ClassificationRobert Santrock MDW. Bret Smith MSc, DOPaul Dayton MS, DPMDaniel Hatch FACFASCategory: Bunion Introduction/Purpose: The most common classification system for HAV deformity is based on two-dimensional radiographs. This system relies upon measurements taken of the transverse plane. (IMA and HVA) to classify and deploy surgical options based on the severity of these angles [1]. Recently, the understanding of HAV deformity as a three-dimensional problem has been described. A study by Kim et al. [2] utilized WB-CT to describe a frontal plane rotational component in 87% HAV cases. To develop a better understanding of HAV, a unique anatomic classification system (see figure) was proposed. The aims of this study were: (1) To use traditional WB radiographs to confirm the findings of Kim’s WB-CT study. (2)To use inter-observer and intra-observer analysis to validate the classification of HAV into this new system. Methods: An Institutional Review Board approved multi-center retrospective study was performed utilizing four view WB radiographs (Anterior-Posterior, Oblique, Lateral and Axial Sesamoid) on patients presenting to the clinic for “bunion,” Hallux Valgus, HAV, Hallux Rigidus or “great toe pain.” The data were analyzed for the presence of frontal/coronal plane rotation of the first metatarsal, subluxation of the sesamoids, metatarsus adductus and degenerative joint disease of the first MTP (metatarsophalangeal) joint (Hallux Rigidus); these findings were compared to Kim’s study. Additionally, these data were used to categorize HAV deformities into a new 3D classification scheme and were tested for inter-observer and intra-observer reliability. Results: The results established the presence of frontal/coronal plane rotation and subluxation in similar ratios as reported by Kim et al. thus confirming the utility of a four-view WB radiograph series in recognition of 3D deformity of HAV. The results also confirmed good reliability of the classification from both the inter-observer and intra-observer standpoint. Conclusion: These data suggest that new protocols and tools are reliable in helping the surgeon recognize and better identify the three-dimensional components of HAV.https://doi.org/10.1177/2473011417S000355 |
| spellingShingle | Robert Santrock MD W. Bret Smith MSc, DO Paul Dayton MS, DPM Daniel Hatch FACFAS Implementation and Validation of Anatomic Triplane Hallux Abducto Valgus Classification Foot & Ankle Orthopaedics |
| title | Implementation and Validation of Anatomic Triplane Hallux Abducto Valgus Classification |
| title_full | Implementation and Validation of Anatomic Triplane Hallux Abducto Valgus Classification |
| title_fullStr | Implementation and Validation of Anatomic Triplane Hallux Abducto Valgus Classification |
| title_full_unstemmed | Implementation and Validation of Anatomic Triplane Hallux Abducto Valgus Classification |
| title_short | Implementation and Validation of Anatomic Triplane Hallux Abducto Valgus Classification |
| title_sort | implementation and validation of anatomic triplane hallux abducto valgus classification |
| url | https://doi.org/10.1177/2473011417S000355 |
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