Clasificaciones de hallux rigidus: ¿todos vemos lo mismo?

Abstract

IntroductionHallux rigidus (HR) is one of the most common causes of pain in the forefoot. We can find 18 different classifications to evaluate this disease without exist nowadays a clear consensus on which to use, although the most widespread it would be Coughlin & Shurnas classification. Making a critical review of the literature we can see that all of them have been developed based on the experience and expert opinion, existing a lack of validity and inter / intra observer reliability studies. ObjectivesTo assess the inter /intraobserver reliability of the classification of Coughlin & Shurnas in their radiological paragraph. Material and Methods6 orthopedic surgeons (2 experts, 2 seniors, 2 novice) analyzed the radiographs (F and P load) of 70 patients with HR and categorized them based on the Coughlin & Shurnas classification. After randomizing the sample, the observation was repeated 3 days after the first. Inter-intraobserver reliability was analyzed using Fleiss Kappa statistic and Kendall Coefficient of Concordance using the statistical package Minitab 16.1.1. ResultsA Fleiss Kappa interobserver reliability of 0.46 and CC Kendall of 0.8183 was obtained. Regarding the internal consistency or intraobserver reliability Fleiss Kappa values ranged from 0.52 and 0.84 for different observers. ConclusionsThe classification of Coughlin & Shurnas in their radiological paragraph has good intraobserver reliability and a moderate interobserver agreement based on our results.