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Letter Regarding: Anterior-Posterior (AP) Calcaneal Profile View: A Novel Radiographic Image to Assess Varus Malalignment

Dear Editor: We read with great interest the cadaveric study recently published by Kwon et al5 entitled “Anterior-Posterior (AP) Calcaneal Profile View: A Novel Radiographic Image to Assess Varus Malalignment,” in which a novel radiographic measurement (the anteroposterior [AP] calcaneal view, dubbed Captain’s view) is described to assess the calcaneal varus malalignment. The premise of the study is that the Harris axial view, which is a radiographic measurement taken with the foot held in dorsiflexion and the beam orientated 35 degrees tangential to the long axis of the calcaneus, may be inaccurate in measuring the calcaneal alignment given the obliquity of the radiograph and the presence of a natural pitch of the bone. In their study, the authors reproduced an oblique calcaneal osteotomy in 5 ankle specimens and compared the Harris view and the Captain’s view in assessing the calcaneal axis at different degrees of varus angulation (10, 20, and 30 degrees). They found that the Captain’s view is more accurate in describing varus malalignment of the calcaneus, especially with greater degrees of varus deformity (ie, 20 and 30 degrees of angulation). While we appreciate the excellent work performed by authors, we would like to make a few points for consideration: