AFCP classification for sagittal plane deformities of the second toe

NewsBot · Sep 18, 2019

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Intra- and inter-observer reliability of the AFCP classification for sagittal plane deformities of the second toe.
Lintz F et al
Foot Ankle Surg. 2019 Aug 29

BACKGROUND:
The French Association of Foot Surgery (AFCP) recently proposed a morphological classification of lesser toe deformities, describing the position of each joint (metatarsophalangeal or MTP, proximal interphalangeal or PIP and distal interphalangeal or DIP) in relation to their anatomic position in the sagittal plane. A study was designed to test its reliability for assessment of sagittal plane deformities of the second toe.

METHODS:
In this retrospective study 55 toes (55 feet, 50 patients) were evaluated. Eleven foot and ankle surgeons assessed independently standardized photographs of each case acquired in a blinded fashion. Assessment was repeated three times, each 15 days apart. Intra- (Intraclass Correlation Coefficient or ICC) and inter-observer reliability (Fleiss' Kappa coefficient) were calculated for each joint.

RESULTS:
Intra- and inter-observer reliability were moderate for the MTP joint (ICC range, 0.54-0.61) (Kappa range, 0.53-0.61) and substantial for the PIP (ICC range, 0.60-0.71) (Kappa range, 0.68-0.75) and DIP joints (ICC range, 0.69-0.78) (Kappa range, 0.74-0.78). Mean assessment time±standard deviation was 35±10s per case.

CONCLUSIONS:
The AFCP classification proved itself reliable in the assessment of sagittal plane defomities of the second toe among eleven foot and ankle surgeons. It is based only on a visual description of the deformity, and does not provide informations on either the clinical reducibility of the deformity and the radiographic joint status.
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NewsBot · Oct 25, 2021

Lesser toe deformity classification: A simplified approach with treatment influence
Zachery Weyandt et al
Foot (Edinb). 2021 Sep;48:101819

Deformities of the lesser toes are one of the most commonly treated conditions by foot and ankle surgeons. Despite their frequency, a standardized classification has yet to take hold among providers. Generic nomenclature with the addition of multiple adjunctive descriptors continues to be the standard leading to international confusion. A literature review was conducted to analyze any literature and/or textbooks pertaining to lesser toe deformity classification systems. Seven sources met the inclusion criteria and were analyzed consisting of novel, modified, and previously published systems. A simplified and treatment driven lesser toe deformity classification utilized at the University of Louisville is introduced, which categorizes these deformities into one of two groups. Type 1 deformities are those isolated to the toe only and Type 2 deformities are toe deformities that include metatarsal phalangeal joint involvement. The intent of the University of Louisville Lesser Toe Deformity Classification (LTDC) is to improve communication and documentation, as well as assist surgical planning.
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