RESUMEN
BACKGROUND: The outcomes of hallux valgus surgery will be measured with reference to two discrete measures of health related quality of life (HRQOL). Clinical, radiographic outcomes and patient satisfaction will also be considered. OBJECTIVES: To assess health related quality of life following rotation scarf and Akin's osteotomies. METHOD: A prospective clinical audit of 71 consecutive patients undergoing surgical repair of hallux valgus. Outcomes included the Manchester Oxford Foot Questionnaire (MOXFQ), EQ-5D, clinical measures, radiographic measures and patient satisfaction. RESULTS: The mean MOXFQ scores improved across the three domains. Walking/standing improved from 54.2 (s.d. 21.4) pre operation to 12 (s.d. 18.1) post operation. Pain improved from 60 (s.d. 19.3) to 15 (s.d. 16.9). Social interaction improved from 53.8 (s.d. 21) to 19.1 (14.6). The improvement in each category was significant, p < 0.0001. EQ-5D scores also improved following intervention. AOFAS scores improved from a pre operation mean of 52.1 to 93.3 post operation (p < 0.0001). All radiographic measures significantly improved (p < 0.0001). CONCLUSIONS: Assessment of outcomes following surgical intervention is of critical importance to the foot surgeon. This study has demonstrated that the combined rotation scarf and Akin's procedure is a reliable procedure, capable of improving a patient's HRQOL.
Asunto(s)
Hallux Valgus/cirugía , Osteotomía/métodos , Calidad de Vida , Auditoría Clínica , Femenino , Hallux Valgus/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Satisfacción del Paciente , Estudios Prospectivos , Radiografía , Conducta Social , Encuestas y Cuestionarios , Caminata/fisiologíaRESUMEN
BACKGROUND: Arthrodesis of the first MTP joint is an accepted and long established joint destructive procedure for the management of hallux rigidus. OBJECTIVES: This paper presents the results of 29 consecutive first MTP joint arthrodesis procedures for the treatment of hallux rigidus. METHOD: The outcomes of 29 (18 female and 11 male) consecutive arthrodesis procedures were analysed with the Foot Health Status Questionnaire (FHSQ), minimal important difference scores, and a patient satisfaction questionnaire. RESULTS: FHSQ foot pain scores improved for 27 (93%) patients; foot function improved for 23 (79%) patients; shoe scores improved for 18 (62%) patients; foot health improved for 20 (68%) patients; general health improved for 12 (41%) patients; physical activity improved for 21 (72%) patients; social capacity improved for 21 (21%) patients; vigour improved for 15 (51%) patients. FHSQ minimal important difference scores were achieved for foot pain in 25 patients (86%); foot function in 17 patients (58%); and general foot health in 19 (65%) patients. Analysis with the matched pairs Wilcoxon rank sum test (p<0.05) revealed statistically significant improvement in all FHSQ domains. Female patients appeared to fare better than male patients in all FHSQ categories other than general health and vigour. CONCLUSION: Arthrodesis of the first MTP joint can reliably reduce pain relating to hallux rigidus and can improve foot function and allow a return to physical activity.