Abstract
Twenty-one symptomatic flat feet from the surgical wait list were compared with twenty-one matched controls. The radiographs were digitized, blinded and the measurements made two occasions by two observers in different order.
On the lateral radiograph the talar to first metatarsal angle reached greatest significance at p< 0.0001, and had an inter and intra observer reliability of 0.83 and 0.75 respectively (r2 value). Only three other of the twelve measurements made reached statistical significance. Radiographic assessment of reconstructive procedures should show restoration of the arch of the foot: We recommend using the talar neck to first metatarsal angle on the lateral view as the correct indicator of loss or restoration of an arch.
The purpose of this study was to determine the radiographic measures that differentiate the symptomatic adult flat foot from a normal foot, and determine the reliability of the measurements.
Although many radiographic measures of flat foot are described, only four out of twelve measurements studied were significantly different between symptomatic adult flat foot and normal adults.
Radiographic assessment of reconstructive procedures should show restoration of the arch of the foot: We recommend using the talar neck to first metatarsal angle on the lateral view as the correct indicator of loss or restoration of an arch.
Twenty-one symptomatic flat feet from the surgical wait list were compared with twenty-one matched controls. Diagnoses included rheumatoid arthritis and posterior tibial tendonitis. All previously described measures of loss of arch were measured on standing AP and lateral radiographs of the foot taken using the same radiographic technique at a single facility. The radiographs were digitized, blinded and the measurements made two occasions by two observers in different order.
On the lateral radiograph the talar to first metatarsal angle reached greatest significance at p< 0.0001, and had an inter and intra observer reliability of 0.83 and 0.75 respectively (r2 value). The medial cuniform to 5th metatarsal height also reached signficance, but had poor intraobserver reliability (r2 =0.09). On the AP view, only the talar head uncoverage distance reached significance (p< 0..0001) but had poor inter and intraobserver reliability (r2=0.05 and 0.08).
Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada
