Effect of Severity of Deformity on Clinical Outcomes of Scarf Osteotomies

Law, Gin Way; Tay, Kae Sian; Lim, Jeremy Wei Sern; Zhang, Karen Ting; Seng, Chusheng; Yeo, Nicholas Eng Meng; Koo, Kevin; Rikhraj, Inderjeet Singh

doi:10.1177/1071100720907387

Cited by 21 publications

(27 citation statements)

References 25 publications

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“…42 Since its formal introduction in the 19th century, hallux valgus (HV) deformity has been one of the most commonly investigated and treated pathologies of the foot owing to its high prevalence and symptomatic nature. 12,27,32,38,41,44,50,52,54,78,96 Although HV has received a considerable amount of scientific attention over the last century, its pathogenesis is still not entirely understood. 23,63…”

Section: Introductionmentioning

confidence: 99%

First Metatarsal Rotation in Hallux Valgus Deformity

2021

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Rotation of the first metatarsal (M1) as a potential etiological factor of hallux valgus (HV) deformity was described relatively early in the description of HV pathoanatomy. However, because biplanar radiographs have been the standard method for imaging HV, clinicians primarily developed measurement methods and corrective operations confined to 2 dimensions, medial-lateral and inferior-superior. Recently, as our understanding of HV pathoanatomy has further developed, aided in part by advanced imaging technology, M1 rotation about its axis (“axial rotation”) and its implications for HV deformity and treatment has reemerged. The goal of this review is to summarize M1 rotation in HV from a historical perspective, to present the current understanding of its potential role in the etiology/pathogenesis of HV, and to summarize relevant imaging and operative considerations with respect to M1 rotation. Level of Evidence: Level III, systematic review.

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Section: Introductionmentioning

confidence: 99%

First Metatarsal Rotation in Hallux Valgus Deformity

2021

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“…Although there was a slightly higher proportion of patients with severe hallux valgus and a slightly lower proportion of patients with moderate hallux valgus in the nondiabetic group, this difference was not significant ( P = .315). In the study by Law et al 18 of 83 feet in 67 patients with a mean age of 50.2 years (range, 19-82 years) to evaluate the impact of hallux valgus severity on clinical outcomes of surgery, the severity of deformity did not negatively affect outcomes. Similarly excellent outcomes and high patient satisfaction were achieved regardless of severity of deformity.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly excellent outcomes and high patient satisfaction were achieved regardless of severity of deformity. 18…”

Section: Discussionmentioning

confidence: 99%

“…Similarly excellent outcomes and high patient satisfaction were achieved regardless of severity of deformity. 18 Good glycemic control is integral in diabetic treatment and control of its related complications. 25 HbA1c is used to monitor long-term glycemic control as it correlates well with the average blood glucose levels 90 to 120 days before measurement.…”

Section: Discussionmentioning

confidence: 99%

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Results of Hallux Valgus Surgery in Diabetic Patients With Good Glycemic Control

et al. 2020

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Background: Literature is sparse on whether diabetes affects outcomes of hallux valgus surgery. With the rising global prevalence of diabetes and diabetes being an independent predictor of poorer outcomes, particularly in foot and ankle surgery, we aimed to investigate the impact of diabetes on the outcomes of hallux valgus surgery. Methods: We conducted a retrospective comparative cohort study of prospectively collected registry data of 951 feet in 721 patients who underwent surgery for symptomatic hallux valgus between 2007 and 2015 at our institution. All patients with diabetes were identified and matched with patients without diabetes for age, sex, and body mass index in a 1:2 ratio to construct the matched cohorts for analysis. Glycemic control in the diabetic cohort was assessed using preoperative HbA1c. The primary outcome measure was complication rates. Secondary outcomes were (1) deformity correction using the hallux valgus and intermetatarsal angles; (2) patient-reported outcomes using visual analog scale (VAS) for pain, Short Form–36 (SF-36) Physical and Mental Health subscales, and American Orthopaedic Foot & Ankle Society (AOFAS) scores; (3) patient satisfaction; and (4) reoperation rates up to 2 years postoperatively. Forty diabetic patients were identified and matched to 80 nondiabetic patients. Although matching was only performed for age, sex, and body mass index, the diabetic and the nondiabetic cohorts were also similar in hallux valgus severity, preoperative scores, and types of procedures performed. Results: The mean preoperative HbA1c in our diabetic cohort was 7.1%. Both the diabetic and nondiabetic cohorts showed excellent AOFAS and VAS scores with no differences in degree of deformity correction, complication profiles, reoperation rates, outcome scores, and satisfaction at both 6 months and 2 years postoperatively. Conclusion: We believe stringent patient selection was key to reduced complication rates and good outcomes in diabetic patients. Well-selected diabetic patients remain suitable candidates for hallux valgus surgery. Level of Evidence: Level III, retrospective comparative study.

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“…Although the relationship between age and the prevalence of hallux valgus has been established, 8,27,28 it is known that the presence and severity of radiographic findings do not correlate with preoperative symptom severity 21 or clinical outcomes following surgical correction. 18,22,37 Given that hallux valgus has been linked to functional disability, 3 gait instability, 24 and increased fall risk in older adults, 25,38 an investigation on the influence of age on the clinical outcomes of hallux valgus correction is also warranted. Small noncomparative studies in elderly patients have been performed.…”

Section: Introductionmentioning

confidence: 99%

Effect of Age on Clinical and Radiological Outcomes of Hallux Valgus Surgery

et al. 2021

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Background: The prevalence of hallux valgus increases with age. However, no studies have compared the effectiveness of surgical correction among different age groups. This study investigated the influence of age on clinical and radiological outcomes following hallux valgus surgery. Methods: Patients who underwent correction for hallux valgus at an academic hospital were stratified into 3 age groups: younger (<50 years), middle-aged (50-59 years), and older (≥60 years). Functional outcomes and satisfaction questionnaires were collected preoperatively and at 6 months and 2 years postoperatively. Radiological recurrence and reoperations were recorded at follow-up. There were 193 patients (93% female): 34 younger, 74 middle-aged, and 85 older. Results: The preoperative hallux valgus angle was significantly greater in older patients ( P < .001). The older group had 3 perioperative complications ( P = .144) and showed a trend toward a longer hospital stay ( P = .083). There was no difference in visual analog scale, American Orthopaedic Foot & Ankle Society score, or SF-36 among the groups at 6 months or 2 years. Using multiple regression, age was not associated with any outcome score. The satisfaction rates were 82%, 78%, and 83% in the young, middle-aged, and older groups, respectively ( P = .698). There was no difference in the number of reoperations at a mean follow-up of 9.2 ± 2.2 years ( P = .778), and no patients underwent reoperation for recurrent hallux valgus. The risk of recurrence was 5 times higher in older patients compared with younger patients (OR, 5.15; 95% CI, 1.10-24.03; P = .037). Conclusion: Age did not influence the perioperative, functional, or subjective outcomes following hallux valgus surgery. However, older patients should be counseled on the higher risk of recurrence following surgical correction. Level of Evidence: Therapeutic, level III, retrospective comparative series.

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Effect of Severity of Deformity on Clinical Outcomes of Scarf Osteotomies

Cited by 21 publications

References 25 publications

First Metatarsal Rotation in Hallux Valgus Deformity

First Metatarsal Rotation in Hallux Valgus Deformity

Results of Hallux Valgus Surgery in Diabetic Patients With Good Glycemic Control

Effect of Age on Clinical and Radiological Outcomes of Hallux Valgus Surgery

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