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Reproducibility and Reliability of the Radiographic Angles Used to Assess Tailor's Bunions

David W. Shofler College of Podiatric Medicine, Western University of Health Sciences, Pomona, CA.

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Bryon McKenna College of Podiatric Medicine, Western University of Health Sciences, Pomona, CA.

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Johnny Huang College of Podiatric Medicine, Western University of Health Sciences, Pomona, CA.

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Robert A. Christman College of Podiatric Medicine, Western University of Health Sciences, Pomona, CA.

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Background:

Tailor's bunion, or bunionette, deformity is a common condition of the lateral forefoot. To aid in assessing the deformity, radiographic angular measurements are frequently used. The objective of this study was to determine the reliability and reproducibility of these angular measurements.

Methods:

Thirty unique weightbearing dorsoplantar digital radiographs of pathologic feet were compiled. For these 30 radiographs and for ten repeated radiographs, six practicing clinicians measured the following angles: the fourth to fifth intermetatarsal angle, the lateral deviation angle, and the fifth metatarsophalangeal angle. Both traditional and modified versions of the fourth to fifth intermetatarsal angle were included.

Results:

Intraclass correlation coefficient values were calculated for each of the angles studied. Intrarater reliability was highest for the fifth metatarsophalangeal angle and lowest for the lateral deviation angle. Intrarater reliability was higher for the traditional fourth to fifth intermetatarsal angle than for the modified version. The interrater reliability calculations revealed parallel findings.

Conclusions:

Accurate assessment is critical when planning for surgical intervention. Awareness of the relative reliability of these radiographic angular measurements can aid in preoperative planning and may be of benefit in procedure selection.

Corresponding author: David W. Shofler, DPM, MSHS, College of Podiatric Medicine, Western University of Health Sciences, 309 E Second St, Pomona, CA 91766-1854. (E-mail: dshofler@westernu.edu)