Article

Age-adjusted baseline data for women with hallux valgus undergoing corrective surgery

Department of Orthopaedic Surgery, University of Southern California, 1200 North State Street, GNH 3900, Los Angeles, CA 90033, USA.
The Journal of Bone and Joint Surgery (Impact Factor: 4.31). 01/2005; 87(1):66-75. DOI: 10.2106/JBJS.B.00288
Source: PubMed

ABSTRACT Functional and health-related quality-of-life data on a population of patients with hallux valgus are lacking. Similarly, the correlation of the severity of the deformity with these measures is unknown.
Two hundred and eighty-five women with an average age of forty-nine years who were scheduled for bunion surgery were enrolled in the study. The patients completed a baseline American Academy of Orthopaedic Surgeons (AAOS) foot and ankle outcomes questionnaire, which includes the Short Form-36 (SF-36) and a specific lower-extremity section on the foot and ankle. Preoperative radiographic data with regard to the hallux valgus angle and the intermetatarsal angle were stratified into groups according to the severity of the deformity (mild, moderate, or severe). The data were then stratified into age-groups consistent with those reported for the SF-36, and the results were compared with the SF-36 scores for the general population. The global foot and ankle score and the shoe comfort score were compared with general population scores that were published previously. The severity of the preoperative deformity was correlated with the baseline scores.
General health scores were noted to be relatively stable throughout the age-groups for patients with bunions, with the older groups demonstrating better scores than the general population. Bodily pain scores were consistently worse for patients with a bunion through all age-groups compared with the general population. The average global foot and ankle score and the shoe comfort score were significantly lower (p < 0.001 for both) for the patients with a bunion than for the general population. The severity of the preoperative deformity did not correlate with any of the outcome scores.
The bodily pain score from the SF-36 appears to be a sensitive measure of problems experienced by patients undergoing bunion surgery. Surprisingly, the severity of the deformity as measured radiographically did not correlate with any of the fifteen scores measured. These data may serve as a baseline for clinical hallux valgus studies with use of the SF-36 or the AAOS outcomes questionnaire.

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    ABSTRACT: RESUMEN. Objetivo: Evaluar la experiencia adquirida en la corrección del hallux valgus me-diante osteotomía metatarsiana distal percutánea. Material y métodos: Estudio retrospectivo en quie-nes se efectuó osteotomía metatarsiana distal per-cutánea entre Mayo de 2005 a Mayo de 2007. Se registraron la edad, sexo, número de pies inter-venidos, evaluación clínica de los resultados a los seis meses de postoperatorio mediante la escala AOFAS y medición de ángulo intermetatarsiano y del ángulo hallux valgus. Resultados: 40 pacien-tes fueron en total, treinta y ocho pacientes fueron mujeres y dos hombres, la edad promedio fue 49 años (28-73 años). Se realizaron 58 osteotomías. Mediante la escala de la AOFAS se calificaron 28 pacientes (41/58 pies) sin dolor. La capacidad fun-cional fue en promedio de 41 puntos y se obtuvo una alineación excelente en 74% de los casos. El ángulo intermetatarsiano en promedio fue de 7.5 grados. En dos pacientes (2 pies) se registraron complicaciones. Conclusiones: Se considera que el tratamiento adecuado para la corrección del ha-llux valgus es mediante procedimientos de cirugía mínimamente invasiva con excepción en aquellos casos en que el estado de la articulación metatar-sofalángica del primer dedo presente signos de artrosis. Palabras clave: osteotomía, hallux valgus, pie, cirugía. ABSTRACT. Objective: To evaluate the expe-rience acquired in hallux valgus correction with percutaneous distal metatarsal osteotomy. Ma-terial and methods: Retrospective study includ-ing patients who underwent percutaneous distal metatarsal osteotomy between May 2005 and May 2007. The age, sex, and number of feet operated on were recorded. The clinical evaluation of results 6 months after surgery using the AOFAS scale, the intermetatarsal angle and the hallux valgus angle were also recorded. Results: A total of 40 patients were included; 38 females and 2 males; mean age was 49 years (28-73 years). Fifty-eight osteotomies were performed. According to the AOFAS scale, 28 patients (41/58 feet) had no pain. The mean functional capacity score was 41 points, and an excellent alignment was achieved in 74% of cases. The mean intermetatarsal angle was 7.5º. Compli-cations occurred in 2 patients (2 feet). Conclusions: The appropriate treatment for the correction of hallux valgus consists of minimally invasive proce-dures, except for the cases in which the metatarso-phalangeal joint shows signs of arthrosis.