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Influence of lower limb rotation on hindfoot alignment using a conventional two-dimensional radiographic technique
L Baverel1, J Brilhault2, G Odri3
1CHU de Nantes, 1 place Alexis Ricordeau, Nantes, France.
Background:
Rotation is one of the variables explaining lack of reproducibility in assessing hindfoot alignment. The hypothesis for this study was that a mathematical model predicts how this modifies radiographic hindfoot alignment measurements.
Methods:
A cadaveric lower limb, disjointed at knee level, was used. Sagittal and coronal planes were fixed using a custom clamp. Standard AP views were shot every five degrees and measured hindfoot alignments were compared to theoretical values obtained from a mathematical simulation.
Results:
Hindfoot angle was 7.04° at 0° rotation and 2.11° at -90°. Intra-class and inter-investigator correlation was 0.863. The t-test showed no significant difference (p=0.73). Intra-investigator correlation was 0.957. The R2 correlation index was 0.852.
Conclusions:
The mathematical model accurately predicted the variations of the hindfoot angle which was maximum when the foot was aligned with the X-rays source. It then decreased when the foot rotated away, following a parabolic curve.
