Authors:	Schippers, Philipp Drees, Philipp Gercek, Erol Wunderlich, Felix Müller, Daniel Ruckes, Christian Meyer, Alexander Klein, Stefan Fischer, Sebastian
Title:	The controversial definition of normal toe alignment
Online publication date:	17-Aug-2023
Year of first publication:	2023
Language:	english
Abstract:	“Normal” and “abnormal” are frequently used in surgical planning and to evaluate surgical results of the forefoot. However, there is no objectifiable value of metatarsophalangeal angles (MTPAs) 2–5 in the dorsoplantar (DP) view with which to objectively evaluate lesser toe alignment. We aimed to determine which angles are considered to be “normal” by orthopedic surgeons and radiologists. Thirty anonymized radiographs of feet were submitted twice in randomized order to determine the respective MTPAs 2–5. After six weeks, the anonymized radiographs and photographs of the same feet without apparent affiliation were presented again. The terms “normal,” “borderline normal,” and “abnormal” were assigned by the observers. Viewers considered MTP-2 alignment from 0° to −20° to be normal, and below −30° abnormal; MTP-3, 0° to −15° to be normal and below −30° abnormal; MTP-4, 0° to −10° normal and below −20° abnormal. Between 5° valgus and 15° varus was the range of MTP-5 recognized as normal. High intra-observer but low interobserver reliability with overall low correlation of clinical and radiographic aspects was observed. The assessment of the terms “normal” or “abnormal” are subject to a high degree of variation. Therefore, these terms should be used cautiously.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-9382
Version:	Published version
Publication type:	Zeitschriftenaufsatz
Document type specification:	Scientific article
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Journal of Clinical Medicine 12 10
Pages or article number:	3509
Publisher:	MDPI
Publisher place:	Basel
Issue date:	2023
ISSN:	2077-0383
Publisher DOI:	10.3390/jcm12103509
Appears in collections:	DFG-491381577-G