Intraoperative assessment of hindfoot alignment using C-arm fluoroscopy

IF 1.5 4区 医学 Q3 ORTHOPEDICS Journal of Orthopaedic Science Pub Date : 2024-09-01 DOI:10.1016/j.jos.2023.08.014
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引用次数: 0

Abstract

Background

Hindfoot malalignment can cause various foot and ankle problems. For better surgical performance and correction of hindfoot malalignments, reliable intraoperative determination of hindfoot alignment is essential. However, there is no standard method for the intraoperative assessment of hindfoot alignment. We devised an intraoperative modified Méary posteroanterior (IOPPA) view to assess intraoperative hindfoot alignment. This study aimed to compare this intraoperative method with other radiographic hindfoot alignment measurements.

Methods

Thirty-seven patients (47 feet) with various foot and ankle conditions scheduled to undergo surgery were prospectively recruited. Before surgery, the Saltzman, long axial, and modified Méary views were taken in a controlled and standardized fashion. IOPPA views were obtained under simulated weight bearing conditions using C-arm fluoroscopy in the operating room before surgery. The relationship between the IOPPA view and the three radiographic hindfoot alignments was evaluated using Pearson's correlation.

Results

The mean hindfoot alignment angle was varus 3.50° (CI, varus 1.91 to 5.08) on the Saltzman view, varus 2.00° (CI, varus 0.60 to 3.39) on the long axial view, varus 0.13° (CI, valgus 1.41 to varus 1.67) on the modified Méary view, and varus 1.32° (CI, valgus 0.02 to varus 2.65) on IOPPA view. The IOPPA view and the three other hindfoot alignment views were found to be significantly correlated (r = 0.60 for the Saltzman view, r = 0.50 for the long axial view, r = 0.71 for the modified Méary view, P < .05). The intraobserver ICC (Intraclass Correlation Coefficient) value was 0.974 and interobserver ICC (Intraclass Correlation Coefficient) value was 0.988 for the IOPPA view (P < .001).

Conclusion

There was a statistically significant correlation between the IOPPA view and the other three hindfoot alignment views. We also found that interobserver and intraobserver ICC values were excellent. This study proposes that the IOPPA view can be used as a reliable intraoperative assessment tool for hindfoot alignment.

Level of evidence

Prospective study.

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使用C型臂荧光镜检查术中评估后脚对齐。
背景:后脚错位会导致各种足部和脚踝问题。为了更好的手术性能和矫正后脚对齐不良,术中可靠的后脚对齐测定至关重要。然而,术中评估后脚对齐没有标准的方法。我们设计了一种术中改良的Méary后前(IOPA)视图来评估术中后脚对齐情况。本研究旨在将这种术中方法与其他放射学后足对齐测量方法进行比较。方法:前瞻性地招募了37名(47英尺)患有各种足部和踝关节疾病并计划接受手术的患者。手术前,Saltzman、长轴和改良的Méary视图是以可控和标准化的方式拍摄的。手术前在手术室使用C型臂荧光镜在模拟承重条件下获得IOPA视图。使用Pearson相关性评估IOPA视图与三种放射学后足对齐之间的关系。结果:Saltzman视野下的平均后足排列角为内翻3.50°(CI,内翻1.91至5.08),长轴视野下的内翻2.00°(CI),改良Méary视野下的外翻0.13°(CI1.41至内翻1.67),IOPA视野下的后足内翻1.32°(CI 0.02至内翻2.65)。IOPA视图和其他三个后足对齐视图被发现显著相关(Saltzman视野为0.60,长轴视野为0.50,改良Méary视野为0.71,P结论:IOPA视野与其他三种后足对齐视野之间存在统计学上显著的相关性。我们还发现观察者间和观察者内ICC值非常好。本研究提出,IOPA视野可作为一种可靠的内窥镜用于后足对齐的ative评估工具。证据水平:前瞻性研究。
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来源期刊
Journal of Orthopaedic Science
Journal of Orthopaedic Science 医学-整形外科
CiteScore
3.00
自引率
0.00%
发文量
290
审稿时长
90 days
期刊介绍: The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
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