Surgery for the correction of hallux valgus

Abstract

This study sought to determine the medium-term patient-reported and radiographic outcomes in patients undergoing surgery for hallux valgus. A total of 118 patients (162 feet) underwent surgery for hallux valgus between January 2008 and June 2009. The Manchester-Oxford Foot Questionnaire (MOXFQ), a validated tool for the assessment of outcome after surgery for hallux valgus, was used and patient satisfaction was sought. The medical records and radiographs were reviewed retrospectively. At a mean of 5.2 years (4.7 to 6.0) post-operatively, the median combined MOXFQ score was 7.8 (IQR:0 to 32.8). The median domain scores for pain, walking/standing, and social interaction were 10 (IQR: 0 to 45), 0 (IQR: 0 to 32.1) and 6.3 (IQR: 0 to 25) respectively. A total of 119 procedures (73.9%, in 90 patients) were reported as satisfactory but only 53 feet (32.7%, in 43 patients) were completely asymptomatic. The mean (SD) correction of hallux valgus, intermetatarsal, and distal metatarsal articular angles was 18.5° (8.8°), 5.7° (3.3°), and 16.6° (8.8°), respectively. Multivariable regression analysis identified that an American Association of Anesthesiologists grade of >1 (Incident Rate Ratio (IRR) = 1.67, p-value = 0.011) and recurrent deformity (IRR = 1.77, p-value = 0.003) were associated with significantly worse MOXFQ scores. No correlation was found between the severity of deformity, the type, or degree of surgical correction and the outcome. When using a validated outcome score for the assessment of outcome after surgery for hallux valgus, the long-term results are worse than expected when compared with the short- and mid-term outcomes, with 25.9% of patients dissatisfied at a mean follow-up of 5.2 years.

Third-Generation Minimally Invasive Chevron and Akin Osteotomies (MICA) in Hallux Valgus Surgery

“…We were unable to identify other studies performing regression analysis for minimally invasive hallux valgus surgery, which prevented us from making comparisons. However, Chong et al performed regression analysis on a population consisting predominantly of patients treated with scarf osteotomies and found no association between radiographic evidence of severity or the degree of correction and the MOXFQ score; the latter finding contradicts ours 37 .…”

Correction of hallux abducto valgus by scarf osteotomy. A ten‐year retrospective multicentre review of patient reported outcomes shows high satisfaction rates with podiatric surgery

“…It is a complicated multiplanar pathology and is characterised by lateral deviation and valgus rotation of the hallux and medial deviation of the first metatarsal [1, 3, 4]. It has been reported that approximately 23% of adults aged between 18 and 65 years have the deformity, which increases to 35.7% of the population above 65 years of age [3]. It has a higher female predilection and can often result in a decreased quality of life [5].…”

“…Hallux abducto valgus (HAV), the bunion deformity, is one of the most common presentations in foot and ankle practice [1, 2]. It is a complicated multiplanar pathology and is characterised by lateral deviation and valgus rotation of the hallux and medial deviation of the first metatarsal [1, 3, 4]. It has been reported that approximately 23% of adults aged between 18 and 65 years have the deformity, which increases to 35.7% of the population above 65 years of age [3].…”