Comparison of radiological improvement in hallux valgus toe deformity after different corrective surgeries and its correlation with patient satisfaction score

摘要

Background: Hallux valgus is the end result of an unstable first ray (or medial column) of the foot.nOver 130 surgical techniques have been described for its management. A surgeon treating halluxnvalgus must have a decision-making strategy to optimize surgical outcome. Comparison of variousntechniques is crucial, and tools used for evaluation of the outcome of surgery should be correctlynselected to improve clinical practice.nAims: In our study, we compared five different surgical techniques. Also we studied whether therenis there a correlation between the degree of angular correction and patient satisfaction score. Thisnwas to determine if the commonly held view that correction of deformity on X-ray after surgery cannbe used as a tool to gauge the success of surgery.nPatients and methods: Between April 2002 and September 2006, 137 patients (153 feet) with mildto-nsevere hallux valgus deformity underwent corrective surgery. Operations included in our studynwere basal osteotomy, distal Chevron’s, Mitchell’s,Wilson’s and Scarfe osteotomies. Two observersnrecorded angular measurements. We measured inter-metatarsal, hallux valgus and distalnmetatarsal articular angle. Joint congruency was also noted in the radiological assessment. Patientnsatisfaction was graded according to the Foot and Ankle Outcome Score (FAOS).nResults: Using a paired t-test, the intra-observer differences were compared for each method andnfor each surgeon. It was found that there is no evidence of a significant difference in angularnmeasurements (P < 0.005). For inter-observer measurements, we found that there is a differencenfor one of the angles (HVA; 95% CI). Using the Mann–Whitney test, we compared the mediannangular improvement for the various techniques and found that basal technique median angularnimprovement is better than others and also that the Wilson technique median angular improvementnis lowest in the group. Using the Pearson’s correlation coefficient it was found that at a 5%nsignificance level there is no correlation between the clinical improvement and the angularnimprovement (P > 0.05; n = 41).