Reliability of the metaphyseal-diaphyseal angle in tibia vara as measured on digital images by pediatric orthopaedic surgeons

Journal of Pediatric Orthopedics
William Francis LavelleDavid M Drvaric

Abstract

Levine and Drennan described the tibial metaphyseal-diaphyseal angle (MDA) in an attempt to identify patients with infantile Blount's disease. Pediatric orthopaedic surgeons have debated not only the use, but also the reliability of this measure. Two techniques have been described to measure the MDA. These techniques involved using both the lateral border of the tibial cortex and the center of the tibial shaft as the longitudinal axis for radiographic measurements. The use of digital images poses another variable in the reliability of the MDA as digital images are used more commonly. The radiographs of 21 children (42 limbs) were retrospectively reviewed by 27 staff pediatric orthopaedic surgeons. Interobserver reliability was determined using the intraclass correlation coefficients (ICCs). Nine duplicate radiographs (18 duplicate limbs) that appeared in the data set were used to calculate ICCs representing the intraobserver reliability. A scatter plot was created comparing the mean MDA determined by the 2 methods. The strength of a linear relationship between the 2 methods was measured with the Pearson correlation coefficient. Finally, we tested for a difference in variability between the 2 measures at angles of 11 degrees or ...Continue Reading

References

Nov 1, 1987·Journal of Pediatric Orthopedics·R T Loder, C E Johnston
Jul 1, 1985·Journal of Pediatric Orthopedics·K A Foreman, W W Robertson
Nov 1, 1993·The Journal of Bone and Joint Surgery. American Volume·M D Feldman, P L Schoenecker
Sep 24, 1998·Journal of Pediatric Orthopedics·E M RaneyJ G Marshall
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Jun 6, 2007·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Michaela GstoettnerChristian M Bach

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Citations

Dec 2, 2014·The Orthopedic Clinics of North America·Sanjeev Sabharwal
Sep 6, 2012·Clinical Orthopaedics and Related Research·Bekhzad AkhmedovMoon Seok Park
Aug 16, 2012·Journal of Pediatric Orthopedics·Philip D NowickiMichelle S Caird
Mar 1, 2010·Asian Journal of Sports Medicine·Ramin EspandarTaghi Baghdadi

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