대한족부족관절학회지 (Journal of Korean Foot and Ankle Society)

  • 제16권3호
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  • Pages.169-174
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  • 2012
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  • 1738-3757(pISSN)
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  • 2288-8551(eISSN)
대한족부족관절학회 (Korean Foot & Ankle Society)
권호 표지

후족부 정렬의 새로운 방사선학적 평가 방법

The New Radiographic Evaluation of Hindfoot Alignment

  • 한우연 (울산대학교 의과대학 서울아산병원 정형외과학교실) ;
  • 이호승 (울산대학교 의과대학 서울아산병원 정형외과학교실) ;
  • 김원경 (울산대학교 의과대학 서울아산병원 정형외과학교실) ;
  • 안지용 (울산대학교 의과대학 서울아산병원 정형외과학교실)
  • Han, Woo-Yeon (Department of Orthopedic Surgery, University of Ulsan, College of Medicine, Asan Medical Center) ;
  • Lee, Ho-Seong (Department of Orthopedic Surgery, University of Ulsan, College of Medicine, Asan Medical Center) ;
  • Kim, Won-Kyeong (Department of Orthopedic Surgery, University of Ulsan, College of Medicine, Asan Medical Center) ;
  • Ahn, Ji-Yong (Department of Orthopedic Surgery, University of Ulsan, College of Medicine, Asan Medical Center)
  • 투고 : 2012.05.29
  • 심사 : 2012.08.21
  • 발행 : 2012.09.15
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초록

Purpose: There are various methods proposed for the evaluation of the hindfoot alignment. However, due to structural calcaneus variances between patients, it is hard to assess this alignment definitively. Thus, this study proposes a new method for evaluating of the hindfoot alignment and its comparisons to the existing current methods. Materials and Methods: This study includes simple weight bearing hindfoot coronal view radiographs of 120 patients, taken between the time period of March 2008 to November 2009. Among the 120 patients, there was a 1:1 ratio of male to female with an average age of 40. The newly proposed method for evaluating this alignment is to draw a moment arm from the point where the sustentaculum tali meets the medial calcaneus border to the most prominent aspect of the lateral process of the calcaneal tuberosity. The angle produced via the intersection of this moment arm to the mid-longitudinal axis of the tibia is found and used to evaluate the hindfoot alignment. The inter and intra-observer reliability was evaluated using the coefficient of intraclass correlation. This study also investigates the comparisons between the newly proposed method to the traditionally used Saltzman et al hindfoot alignment evaluating technique. Results: The newly proposed method has higher inter and intra-observer reliability than the existing traditional Saltzman et al technique. Conclusion: This new method is recommended over the traditionally used Saltzman et al technique as it has a stronger confidence level and is appropriate for assessing hindfoot alignment in simple radiographs.

키워드

참고문헌

  1. Buck FM, Hoffmann A, Mamisch-Saupe N, Espinosa N, Resnick D, Hodler J. Hindfoot alignment measurements: rotation-stability of measurement techniques on hindfoot alignment view and long axial view radiographs. AJR Am J Roentgenol. 2011;197:578-582. https://doi.org/10.2214/AJR.10.5728
  2. Johnson JE, Lamdan R, Granberry WF, Harris GF, Carrera GF. Hindfoot coronal alignment: a modified radiographic method. Foot Ankle Int. 1999;20:818-825. https://doi.org/10.1177/107110079902001212
  3. Lee WC, Moon JS, Lee HS, Lee K. Alignment of ankle and hindfoot in early stage ankle osteoarthritis. Foot Ankle Int. 2011;32:693-699. https://doi.org/10.3113/FAI.2011.0693
  4. Haight HJ, Dahm DL, Smith J, Krause DA. Measuring standing hindfoot alignment: reliability of goniometric and visual measurements.Arch Phys Med Rehabil. 2005;86:571-575. https://doi.org/10.1016/j.apmr.2004.05.014
  5. Reilingh ML, Beimers L, Tuijthof GJM, Stufkens SAS, Maas M, van Dijk CN. Measuring hindfoot alignment radiographically: the long axial view is more reliable than the hindfootalignment view. Skeletal Radiol. 2010;39:1103-1108. https://doi.org/10.1007/s00256-009-0857-9
  6. Strash WW, Berardo P. Radiographic assessment of the hindfoot and ankle. ClinPodiatr Med Surg. 2004;21:295-304. https://doi.org/10.1016/j.cpm.2004.03.004
  7. Tuijthof GJM, Herder JL, Scholten PE, van Dijk CN, Pistecky PV. Measuring alignment of the hindfoot.J Biomech Eng. 2004;126:357-362. https://doi.org/10.1115/1.1762897
  8. Saltzman CL, el-Khoury GY. The hindfoot alignment view.Foot Ankle Int. 1995;16:572-576. https://doi.org/10.1177/107110079501600911
  9. Shrout PE, Fleiss JL. Intraclass correlations: uses inassessing rater reliability. Psychol Bull. 1979;86:420-428. https://doi.org/10.1037/0033-2909.86.2.420
  10. Hintermann B, Knupp M, Barg A. Osteotomies of the distal tibia and hindfoot for ankle realignment. Orthopade. 2008;37:212-223. https://doi.org/10.1007/s00132-008-1214-8
  11. Lee HS, Wapner KL, Park SS, Kim JS, Lee DH, Sohn DW. Ligament reconstruction and calcaneal osteotomy for osteoarthritis of the ankle.Foot Ankle Int. 2009;30:475-480. https://doi.org/10.3113/FAI.2009.0475
  12. Lee WC, Moon JS, Lee K, Byun WJ, Lee SH. Indications for supramalleolar osteotomy in patients with ankle osteoarthritis and varus deformity. J Bone Joint Surg Am. 2011;93:1243-1248. https://doi.org/10.2106/JBJS.J.00249
  13. Pagenstert GI, Hintermann B, Barg A, Leumann A, Valderrabano V. Realignment surgery as alternative treatment of varus and valgus ankle osteoarthritis. ClinOrthopRelat Res. 2007;462:156-168.
  14. Stamatis ED, Cooper PS, Myerson MS. Supramalleolar osteotomy for the treatment of distal tibial angular deformities and arthritis of the ankle joint. Foot Ankle Int. 2003;24:754-764. https://doi.org/10.1177/107110070302401004
  15. Takakura Y, Tanaka Y, Kumai T, Tamai S. Low tibial osteotomy for osteoarthritis of the ankle. Results of a new operation in 18 patients.J Bone Joint Surg Br. 1995;77:50-54.
  16. Takakura Y, Takaoka T, Tanaka Y, Yajima H, Tamai S. Results of opening-wedge osteotomy for the treatment of a post-traumatic varus deformity of the ankle. J Bone Joint Surg Am. 1998;80:213-218. https://doi.org/10.2106/00004623-199802000-00008
  17. Tanaka Y, Takakura Y, Hayashi K, Taniguchi A, Kumai T, Sugimoto K. Low tibial osteotomy for varus-type osteoarthritis of the ankle. J Bone Joint Surg Br. 2006;88: 909-913. https://doi.org/10.2106/JBJS.E.01398
  18. Hayashi K, Tanaka Y, Kumai T, Sugimoto K, Takakura Y. Correlation of compensatory alignment of the subtalar joint to the progression of primary osteoarthritis of the ankle. Foot Ankle Int. 2008;29:400-406. https://doi.org/10.3113/FAI.2008.0400