Evidence map›Paper›PMID 37240615›Full record

ArticleJournal of clinical medicine2023

The Controversial Definition of Normal Toe Alignment.

Philipp Schippers, Philipp Drees, Erol Gercek, Felix Wunderlich, Daniel Müller, Christian Ruckes, Alexander Meyer, Stefan Klein, Sebastian Fischer

Abstract read
In one paragraph

Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Restoration of preoperative tibial alignment improves functional results after medial unicompartmental knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Philipp SchippersDepartment of Orthopedics and Traumatology, University Medical Center of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany.
Philipp DreesDepartment of Orthopedics and Traumatology, University Medical Center of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany.
Erol GercekDepartment of Orthopedics and Traumatology, University Medical Center of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany.
Felix WunderlichDepartment of Orthopedics and Traumatology, University Medical Center of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany.
Daniel MüllerDepartment of Trauma, Hand, and Reconstructive Surgery, Goethe-Universität Frankfurt am Main, 60596 Frankfurt, Germany.
Christian RuckesInterdisciplinary Centre for Clinical Trials Mainz, University Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, Germany.
Alexander MeyerCenter for Orthopedics, Spine and Trauma Surgery, St. Josefs-Hospital, 65189 Wiesbaden, Germany.
Stefan KleinDepartment of Diagnostic and Interventional Radiology, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, 60389 Frankfurt, Germany.
Sebastian FischerDepartment of Foot and Ankle Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, 60389 Frankfurt, Germany.ORCID 0000-0002-9842-2249

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

"Normal" and "abnormal" are frequently used in surgical planning and to evaluate surgical results of the forefoot. However, there is no objectifiable value of metatarsophalangeal angles (MTPAs) 2-5 in the dorsoplantar (DP) view with which to objectively evaluate lesser toe alignment. We aimed to determine which angles are considered to be "normal" by orthopedic surgeons and radiologists. Thirty anonymized radiographs of feet were submitted twice in randomized order to determine the respective MTPAs 2-5. After six weeks, the anonymized radiographs and photographs of the same feet without apparent affiliation were presented again. The terms "normal," "borderline normal," and "abnormal" were assigned by the observers. Viewers considered MTP-2 alignment from 0° to -20° to be normal, and below -30° abnormal; MTP-3, 0° to -15° to be normal and below -30° abnormal; MTP-4, 0° to -10° normal and below -20° abnormal. Between 5° valgus and 15° varus was the range of MTP-5 recognized as normal. High intra-observer but low interobserver reliability with overall low correlation of clinical and radiographic aspects was observed. The assessment of the terms "normal" or "abnormal" are subject to a high degree of variation. Therefore, these terms should be used cautiously.

Indexed as

forefootmetatarsophalangeal angleparabolatoe alignmenttransverse plane

Identifiers

PMID37240615
PMCPMC10218812

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.