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Related Experiment Video

Updated: Jul 8, 2025

An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
15:04

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The Triplanar Hallux Abducto Valgus Classification System: Is it Valid?

Alexander Padovano1, Joshua N Tennant1, Kevin Martin2

  • 1Department of Orthopaedic Surgery, University of North Carolina, Chapel Hill, NC.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|December 17, 2023
PubMed
Summary

The triplanar hallux abducto valgus classification system, intended to improve hallux valgus deformity assessment, was found to be unreliable. Inter-reader agreement was poor, indicating limited clinical utility for this new system.

Keywords:
bunionhallux valguslapidustarsometatarsal arthrodesistriplanar correction

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Area of Science:

  • Orthopedics
  • Radiology
  • Surgical Classification Systems

Background:

  • Traditional 2D radiography is used for hallux valgus deformity classification and treatment guidance.
  • A novel triplanar hallux abducto valgus (HAV) classification system has been proposed, considering alignments in three planes.
  • This triplanar system aims to clarify deformity and guide treatment algorithmically.

Purpose of the Study:

  • To assess the reliability of the recently proposed triplanar hallux abducto valgus classification system.
  • To determine if the triplanar classification system demonstrates consistent results among different evaluators.
  • To validate the prognostic value and reliability of the triplanar HAV classification.

Main Methods:

  • Retrospective review of digital radiographs from 75 patients with hallux abducto valgus.
  • Independent classification of deformities by three fellowship-trained orthopedic foot and ankle surgeons.
  • Randomized re-evaluation after an 8-week washout period to assess inter-reader and intra-reader reliability.

Main Results:

  • The average kappa value for agreement among the three readers was 0.241, indicating only fair agreement.
  • Inter-reader agreement was found to be poor, with a kappa value of 0.046.
  • The triplanar hallux abducto valgus classification system demonstrated low reliability.

Conclusions:

  • The triplanar hallux abducto valgus classification system is not a reliable method for classifying hallux valgus deformities.
  • The system currently lacks sufficient prognostic value and demonstrated poor reliability in this validation study.
  • Further research is needed to refine or develop more reliable multiplanar classification systems for hallux valgus.