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Related Experiment Video

Updated: Jan 19, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Interobserver Analysis of Standard Foot and Ankle Radiographic Angles.

Michael D Gibboney1, Guido A LaPorta2, Mark A Dreyer3

  • 1Staff Podiatrist, Naval Medical Center Camp Lejeune, Camp Lejeune, NC.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|September 19, 2019
PubMed
Summary
This summary is machine-generated.

Standard foot and ankle radiographs are crucial for surgical planning. This study validates normal angles but finds the tibio-second metatarsal angle unreliable for deformity assessment.

Keywords:
calcaneal axialheel axialnormal ankle anglesnormal foot anglesradiographic measurements

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Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Biomechanical Analysis

Background:

  • Standard foot and ankle radiographs are essential for surgical planning and determining normal versus abnormal relationships.
  • Previous studies have established average angles to provide a framework for analysis.

Purpose of the Study:

  • To validate previously documented normal foot and ankle angles using a larger observer group and more angles.
  • To assess the reliability of specific radiographic angles in evaluating foot and ankle deformities.

Main Methods:

  • Measurement of 8 angles on 100 patients by 18 observers (physicians, residents, students).
  • Analysis of intraclass correlation coefficients to determine interobserver reliability.
  • Statistical analysis to validate established normal angles and identify unreliable ones.

Main Results:

  • The study validated previously documented normal foot and ankle angles.
  • The tibio-second metatarsal angle on the calcaneal axial view was found to be unreliable for evaluating foot and ankle deformity.
  • Measurement variability was observed based on observer training level, with residents showing the highest accuracy.

Conclusions:

  • Standard foot and ankle radiographs remain essential for accurate surgical planning.
  • Understanding normal radiographic parameters is critical for differentiating between normal and abnormal foot and ankle structures.
  • Certain radiographic measurements, like the tibio-second metatarsal angle on axial view, require cautious interpretation due to unreliability.