A longitudinal study of hallux valgus surgical outcomes using a validated patient centred outcome measure
Section snippets
Background
Hallux valgus is a common chronic condition affecting up to a third of the population [1]. Progressive disruption to the complex anatomy of the first ray involving metatarsal, sesamoids and hallux impose both structural and functional alteration to the foot which underpin the secondary pathologies associated with this condition [2]. It is common for patients to seek correction of the deformity in order to alleviate pain and improve footwear tolerance. Surgical intervention remains the only
Methods
All patients attending the Department of Podiatric Surgery, Solihull Care Trust between July 2004 and October 2007 for the surgical management of hallux valgus were invited to complete a FHSQ survey. Recruitment design was a consecutive case series with decision to treat as part of standard department process. All procedures were undertaken at one of two surgical centres. However, all were performed by the same podiatric surgeon, thus removing potential inter-reliability bias. Post operative
Demographic and global results
A total of 179 complete data sets were recorded in this longitudinal study with an average participant age of 49.4 years (SD 14.5). The group comprised 164 females and 15 males. The mean days for administration of the FHSQ post operative follow up was 1045 days (149 weeks or 2.9 years).
Results for the global anchor question demonstrated that 82 participants (45.8%) perceived their original foot condition was “much better” (Fig. 1). Additionally, a further 86 subjects (48%) reported their
Discussion
Decision making around clinical and surgical interventions should where possible be evidenced based to ensure that the most clinically effective treatment is offered. In today's society the economic burden of healthcare is well recognised and plays a central role in the delivery of many agreed clinical pathways. To date most of the attention has been focused on high cost areas such as drug treatments for cancer and chronic inflammatory joint diseases. Intense scrutiny in many other areas has
Conclusions
The authors have presented for the first time MIDs for all eight domains for the FHSQ quality of life tool in respect to hallux valgus surgery. Results demonstrate that surgical correction of hallux valgus undertaken under local anaesthetic as a Day Case procedure is an effective intervention directly benefiting patients by reducing perceived foot pain, improving foot function and general foot health for the majority of patients.
Competing interests
The authors declare that they have no significant competing financial, professional or personal interests that might have influenced the performance or presentation of the work described in this manuscript.
Authors’ contributions
SAM carried out the data collection and surgical interventions. MCS conducted the data analysis. MCS, FLB and SAM contributed to the papers construction, read and approved the final manuscript.
Acknowledgements
The authors wish to thank Dr Alan Borthwick for his help and advice in compiling this manuscript.
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Health-related quality-of-life improvement after hallux valgus corrective surgery
2021, Foot and Ankle SurgeryCitation Excerpt :Hallux plantar flexion and abduction strength was negatively correlated to the severity of hallux valgus, which could contribute to the functional disability and increased risk of falls in patients with hallux valgus [27]. Correction of hallux valgus can reduce pain and improve mobility, directly improving physical function, role-physical, bodily pain, and therefore the physical component of QoL, similar to findings reported by Thordanson et al. and Spruce et al. [24,28]. However, correction of hallux valgus contributed negligibly to the improvement of patients’ overall mental health status.
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2020, Foot and Ankle ClinicsCitation Excerpt :Perioperative local analgesia can significantly influence postoperative pain. One randomized study compared combination local analgesia in the form of ropivacaine, morphine, ketorolac, and epinephrine compared with normal saline and demonstrated significantly improved analgesia that was sustained to 1 to 2 days postoperatively.39 Following hallux valgus surgery, optimal oral analgesia is critical in reducing length of stay, readmission rate, and optimizing cost-effectiveness.
Changes in mood state after day case forefoot surgery
2014, Journal of Foot and Ankle SurgeryOutcome after metatarsal osteotomy for hallux valgus: A study of postoperative foot function using revised foot function index short form
2013, Journal of Foot and Ankle SurgeryCitation Excerpt :However, their study lacked the preoperative data to allow accurate comparisons with the postoperative data (14). In a similar study regarding patient outcomes using a validated scoring system, Spruce et al (15) showed that patients reported a statistically significant improvement in foot pain, foot function, and general foot health using a Foot Health Status questionnaire but failed to attain the calculated minimal important difference in the domains related to general health, physical activity, vigor, and social capacity. The attrition rate of the enrolled patients within our study was a limitation and, unfortunately, could not be controlled.
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These authors contributed equally to this work.