Goniometric versus computerized angle measurement in assessing hallux valgus

Area of Science:

• Orthopedic surgery
• Medical imaging analysis
• Biomechanical measurement

Background:

• Digital workstations are increasingly used for radiographic interpretation, replacing traditional film methods.
• Assessing foot angles like hallux valgus (HV) and 1-2 intermetatarsal (IM) is crucial for bunion surgery planning.
• The reliability of these measurements using digital platforms has not been extensively validated.

Purpose of the Study:

• To compare the reliability of measuring HV and 1-2 IM angles using plain film versus digital workstations.
• To validate the use of computer-assisted angle measurement software for preoperative radiographic assessment.

Main Methods:

• Preoperative radiographs of 25 bunion surgery patients were analyzed.
• Measurements were taken using a standardized film technique with a goniometer and compared to digital measurements with computer software.
• Three surgeons performed multiple readings at different intervals, totaling 1,800 measurements.

Main Results:

• Computerized measurements on digital workstations demonstrated superior overall reliability for HV angle.
• Interobserver agreement for HV angle improved from 66% with plain films to 81% with digital workstations (p < 0.001).
• Intraobserver agreement for HV angle increased from 72% to 80%; 1-2 IM angle reliability was similar between methods.

Conclusions:

• Digital workstation-assisted measurement of HV and 1-2 IM angles is validated for clinical use.
• Computerized methods enhance measurement reliability by minimizing goniometer-related errors and allowing precise line adjustments.
• This technology supports more accurate preoperative planning for bunion procedures.