The role of weightbearing computed tomography in assessing first metatarsal pronation in hallux valgus: A systematic review
Bibliographic record
Abstract
BACKGROUND: Hallux valgus is a multiplanar deformity often involving first metatarsal pronation. Weightbearing computed tomography may improve assessment compared to standard radiographs, which are limited to two-dimensional views. METHODS: A systematic review was conducted according to PRISMA guidelines. PubMed and Cochrane databases were searched for studies evaluating weightbearing computed tomography in assessing HV components, including metatarsal pronation and sesamoid position. Study quality was assessed using the Newcastle-Ottawa Scale. RESULTS: Fourteen studies (706 feet) were included. Weightbearing computed tomography consistently outperformed Weightbearing radiographs in detecting first metatarsal pronation and allowed more accurate differentiation between intrinsic torsion and joint malalignment. Pronation and sesamoid displacement were correlated, though thresholds and clinical significance varied. Nine studies were low risk of bias. CONCLUSIONS: Weightbearing computed tomography provides a more accurate and reproducible assessment of metatarsal pronation and sesamoid alignment than weightbearing radiographs. However, its clinical impact remains uncertain. Future studies should standardize measurements and assess whether pronation correction improves surgical outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.065 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.009 |
| Bibliometrics | 0.011 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".