Abstract
BackgroundThe relationship between metatarsal length and various forefoot pathologies is a topic of contention in Orthopaedics. The results of such investigations have been shown to depend on the method of metatarsal length measurement used. The aim of this study was to assess the inter- and intra-rater reliability of the Maestro and Barroco metatarsal length measurement techniques.MethodsA retrospective and quantitative study was performed on 15 randomly selected radiographs to determine the reliability of the two measurement techniques across all five metatarsals (M1 to M5). This was done at one week apart for three weeks by three raters. The intraclass correlation coefficient (ICC), and the 95% lower confidence limit (95% LCL) were calculated.ResultsThe Maestro and Barroco techniques produced high to very high ICC vlaues for length measurements across all metatarsals. The 95% lower confidence limit for inter-rater measurements ranged between 0.92–0.98 for Maestro’s and 0.86–0.99 for Barroco’s technique. For intra-rater measurements the 95% LCL ranged between 0.83–0.99 for Maestro’s and 0.75–0.99 for Barroco’s technique.ConclusionsOur study found that both the Maestro and Barroco methods of measurements produced high to very high inter- and intra-rater reliability. Both methods may be suitable for the use of peri-operative planning and clinical research relating metatarsal length and forefoot pathology. Besides having a more simplistic method of application, the novel Barroco technique is comparable to the more established Maestro method in both repeatability and reproducibility.
Highlights
The relationship between metatarsal length and various forefoot pathologies is a topic of contention in Orthopaedics
In order to determine the intra- and inter-rater reliability of the measurement techniques, intraclass correlation coefficients (ICCs) and the 95% lower confidence limit (95% Lower-confidence limits (LCL)) were calculated for the lengths of metatarsal one (M1) to metatarsal five (M5)
The mean and standard error of the mean (SEM) values in centimetre for each metatarsal length by each rater is given for Maestro and Barroco’s technique in Tables 1 and 2 respectively
Summary
The relationship between metatarsal length and various forefoot pathologies is a topic of contention in Orthopaedics. Different forefoot morphologies due to variation in first metatarsal length relative to the 2nd metatarsal has led to multiple terms, such as Greek foot (index minus), Egyptian foot (index plus) and Roman foot (index plus-minus) as depicted in Fig. 1 [1]. These forefoot morphologies have been controversial in the literature, especially in relation to normality and possible association with forefoot pathology [1,2,3,4,5,6,7,8,9].
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