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The Grading of Hallux Valgus
The Manchester Scale
Adam P. Garrow
,
Ann Papageorgiou
,
Alan J. Silman
,
Elaine Thomas
,
Malcolm I. V. Jayson
, and
Gary J. Macfarlane
This article describes a new, noninvasive method of assessing the severity of hallux valgus deformity by means of a set of standardized photographs. Six podiatrists were independently asked to grade the level of deformity of 13 subjects (26 feet) on a scale of 1 (no deformity) to 4 (severe deformity). The reliability of the four-point scale for the severity of hallux valgus was investigated by means of kappa-type statistics for more than two raters. The results showed that the grading method had excellent interobserver repeatability with a combined kappa-type statistic of 0.86, making it a suitable instrument for clinical and research purposes. (J Am Podiatr Med Assoc 91(2): 74-78, 2001)
