Radiographic measurements of hallux angles: A review of current techniques

Background: Radiographic angles are commonly used in patients with hallux valgus deformity to assess the severity, plan surgery, assess outcome and compare results. Many different manual methods have been used, but are prone to error. More recently computer-assisted methods using software have become available. Objective: To review the different methods that have been used to measure radiographic angles in hallux valgus. Method: A general literature search using relevant key words was undertaken using databases such as Medline, Embase, Cinahl and Cochrane Library. Review findings and discussion: The manual methods used are prone to errors. The reliability can be improved by using standardised radiographic technique and measurement technique using specific reference points. Computer-assisted methods using software, might improve reliability of measurements. Further studies are needed to assess if these methods are easy to use, and to compare different software's that are available. Specifically designed software for the foot might further improve the reliability of radiographic measurements in hallux valgus. © 2009 Elsevier Ltd.