Does it matter how we measure metatarsal length?
Abstract Introduction Variations in the relative lengths of the metatarsal bones have been implicated as a cause of forefoot pain. Osteotomies to balance the metatarsal lengths have been described as therapy. Although measurement of metatarsal length is required for these osteotomies, there is no go...
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Published in | Foot and ankle surgery Vol. 17; no. 3; pp. 124 - 127 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
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Elsevier Ltd
01.09.2011
Elsevier |
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Abstract | Abstract Introduction Variations in the relative lengths of the metatarsal bones have been implicated as a cause of forefoot pain. Osteotomies to balance the metatarsal lengths have been described as therapy. Although measurement of metatarsal length is required for these osteotomies, there is no gold standard method to measure it radiologically. We compared the three main radiological methods to measure the second metatarsal length described in the literature. Materials and Methods Standing dorsoplantar radiographs of 81 feet were measured using the methods described by Coughlin, Maestro and Hardy and Clapham. Bland and Altman's method was used to compare the above techniques for reproducibility and agreement between each method. Results The three methods produced markedly different results. Coughlin's and Maestro's methods showed a relative protrusion of the second metatarsal—relatively longer than the first metatarsal by an average of 4 & 3 mm respectively. Hardy and Clapham's method, however, showed a relative retraction of second metatarsal by an average of 1 mm. Both intra-observer and inter-observer errors were smallest for the Coughlin method (the most reproducible) and largest for the Hardy/Clapham method. Significant lack of agreement was found when we compared the 3 techniques with bias for measuring the mean between methods ranging from 1 mm to 5.5 mm. Conclusions Metatarsal lengths as measured by these three methods can be very variable. Thus their role in planning metatarsal osteotomies and establishing relationship of metatarsal protrusion with metatarsophalangeal joint instability and other similar conditions is questionable and require further studies. |
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AbstractList | INTRODUCTIONVariations in the relative lengths of the metatarsal bones have been implicated as a cause of forefoot pain. Osteotomies to balance the metatarsal lengths have been described as therapy. Although measurement of metatarsal length is required for these osteotomies, there is no gold standard method to measure it radiologically. We compared the three main radiological methods to measure the second metatarsal length described in the literature.MATERIALS AND METHODSStanding dorsoplantar radiographs of 81 feet were measured using the methods described by Coughlin, Maestro and Hardy and Clapham. Bland and Altman's method was used to compare the above techniques for reproducibility and agreement between each method.RESULTSThe three methods produced markedly different results. Coughlin's and Maestro's methods showed a relative protrusion of the second metatarsal-relatively longer than the first metatarsal by an average of 4 & 3 mm respectively. Hardy and Clapham's method, however, showed a relative retraction of second metatarsal by an average of 1 mm. Both intra-observer and inter-observer errors were smallest for the Coughlin method (the most reproducible) and largest for the Hardy/Clapham method. Significant lack of agreement was found when we compared the 3 techniques with bias for measuring the mean between methods ranging from 1mm to 5.5mm.CONCLUSIONSMetatarsal lengths as measured by these three methods can be very variable. Thus their role in planning metatarsal osteotomies and establishing relationship of metatarsal protrusion with metatarsophalangeal joint instability and other similar conditions is questionable and require further studies. Variations in the relative lengths of the metatarsal bones have been implicated as a cause of forefoot pain. Osteotomies to balance the metatarsal lengths have been described as therapy. Although measurement of metatarsal length is required for these osteotomies, there is no gold standard method to measure it radiologically. We compared the three main radiological methods to measure the second metatarsal length described in the literature. Standing dorsoplantar radiographs of 81 feet were measured using the methods described by Coughlin, Maestro and Hardy and Clapham. Bland and Altman's method was used to compare the above techniques for reproducibility and agreement between each method. The three methods produced markedly different results. Coughlin's and Maestro's methods showed a relative protrusion of the second metatarsal-relatively longer than the first metatarsal by an average of 4 & 3 mm respectively. Hardy and Clapham's method, however, showed a relative retraction of second metatarsal by an average of 1 mm. Both intra-observer and inter-observer errors were smallest for the Coughlin method (the most reproducible) and largest for the Hardy/Clapham method. Significant lack of agreement was found when we compared the 3 techniques with bias for measuring the mean between methods ranging from 1mm to 5.5mm. Metatarsal lengths as measured by these three methods can be very variable. Thus their role in planning metatarsal osteotomies and establishing relationship of metatarsal protrusion with metatarsophalangeal joint instability and other similar conditions is questionable and require further studies. Variations in the relative lengths of the metatarsal bones have been implicated as a cause of forefoot pain. Osteotomies to balance the metatarsal lengths have been described as therapy. Although measurement of metatarsal length is required for these osteotomies, there is no gold standard method to measure it radiologically. We compared the three main radiological methods to measure the second metatarsal length described in the literature. Standing dorsoplantar radiographs of 81 feet were measured using the methods described by Coughlin, Maestro and Hardy and Clapham. Bland and Altman's method was used to compare the above techniques for reproducibility and agreement between each method. The three methods produced markedly different results. Coughlin's and Maestro's methods showed a relative protrusion of the second metatarsal—relatively longer than the first metatarsal by an average of 4 & 3 mm respectively. Hardy and Clapham's method, however, showed a relative retraction of second metatarsal by an average of 1 mm. Both intra-observer and inter-observer errors were smallest for the Coughlin method (the most reproducible) and largest for the Hardy/Clapham method. Significant lack of agreement was found when we compared the 3 techniques with bias for measuring the mean between methods ranging from 1 mm to 5.5 mm. Metatarsal lengths as measured by these three methods can be very variable. Thus their role in planning metatarsal osteotomies and establishing relationship of metatarsal protrusion with metatarsophalangeal joint instability and other similar conditions is questionable and require further studies. Abstract Introduction Variations in the relative lengths of the metatarsal bones have been implicated as a cause of forefoot pain. Osteotomies to balance the metatarsal lengths have been described as therapy. Although measurement of metatarsal length is required for these osteotomies, there is no gold standard method to measure it radiologically. We compared the three main radiological methods to measure the second metatarsal length described in the literature. Materials and Methods Standing dorsoplantar radiographs of 81 feet were measured using the methods described by Coughlin, Maestro and Hardy and Clapham. Bland and Altman's method was used to compare the above techniques for reproducibility and agreement between each method. Results The three methods produced markedly different results. Coughlin's and Maestro's methods showed a relative protrusion of the second metatarsal—relatively longer than the first metatarsal by an average of 4 & 3 mm respectively. Hardy and Clapham's method, however, showed a relative retraction of second metatarsal by an average of 1 mm. Both intra-observer and inter-observer errors were smallest for the Coughlin method (the most reproducible) and largest for the Hardy/Clapham method. Significant lack of agreement was found when we compared the 3 techniques with bias for measuring the mean between methods ranging from 1 mm to 5.5 mm. Conclusions Metatarsal lengths as measured by these three methods can be very variable. Thus their role in planning metatarsal osteotomies and establishing relationship of metatarsal protrusion with metatarsophalangeal joint instability and other similar conditions is questionable and require further studies. |
Author | Chauhan, D., MRCS Barrie, J.L., FRCS Bhutta, M.A., MRCS |
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Cites_doi | 10.1016/S1083-7515(03)00148-7 10.1177/107110070402500306 10.1016/S0301-5629(02)00744-5 10.1177/107110070502601209 10.3113/FAI.2008.0142 10.1016/j.fas.2008.04.004 10.1302/0301-620X.87B11.16590 10.2106/00004623-198062050-00005 10.1177/107110079902001003 10.1016/j.fas.2004.07.002 10.1097/01.blo.0000229354.96996.3e 10.1177/107110070602700304 10.1177/107110070002100502 10.3113/FAI.2007.1223 10.1177/107110078900900502 10.1177/107110070402500902 10.1177/107110078700800108 10.1016/S0140-6736(86)90837-8 |
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Keywords | Metatarsal measurement Metatarsalgia Measurement techniques Metatarsal bone Measurement technique Rheumatology |
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Snippet | Abstract Introduction Variations in the relative lengths of the metatarsal bones have been implicated as a cause of forefoot pain. Osteotomies to balance the... Variations in the relative lengths of the metatarsal bones have been implicated as a cause of forefoot pain. Osteotomies to balance the metatarsal lengths have... INTRODUCTIONVariations in the relative lengths of the metatarsal bones have been implicated as a cause of forefoot pain. Osteotomies to balance the metatarsal... |
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SubjectTerms | Adult Aged Aged, 80 and over Anthropometry - methods Biological and medical sciences Diseases of the osteoarticular system Female Humans Male Measurement techniques Medical sciences Metatarsal Bones - anatomy & histology Metatarsal Bones - diagnostic imaging Metatarsal measurement Metatarsalgia Middle Aged Orthopedics Radiography Reproducibility of Results |
Title | Does it matter how we measure metatarsal length? |
URI | https://www.clinicalkey.es/playcontent/1-s2.0-S1268773110000317 https://dx.doi.org/10.1016/j.fas.2010.02.006 https://www.ncbi.nlm.nih.gov/pubmed/21783070 https://search.proquest.com/docview/879103723 |
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