CLINICAL ARTICLE

 

Comparison between unilateral and bilateral hallux valgus corrective surgery with respect to pain/tolerance and cost effectiveness

 

 

NP Saragas

MBBCh (Wits), FCS(SA)Ortho, MMed(Ortho Surg)(Wits); Netcare Linksfield Orthopaedic Sports & Rehabilitation Centre (Clinic), Johannesburg; Orthopaedic Department, University of the Witwatersrand, Johannesburg, South Africa

Correspondence

 

 

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ABSTRACT

BACKGROUND: Bilateral sequential (under one anaesthetic) hallux valgus surgery is considered by many to be too debilitating and uncomfortable to the patient in the short term post-operative period (up to 6 weeks), and should be staged.
METHOD: This retrospective study evaluates tolerance to pain, comfort and activities of daily living during the first 6 weeks post-operatively, as well as cost effectiveness in patients who had unilateral compared to those who had bilateral sequential forefoot surgery (limited to hallux valgus corrective surgery with/without lesser toe surgery). A questionnaire on pain and function was used. The functional outcome was graded by the AOFAS clinical rating system and the correction assessed clinically and radiologically.
RESULTS: The results for pain and patient tolerance/comfort profile over time, for the two groups did not differ significantly. Cost and time factors were shown to be more favourable ultimately, in the bilateral hallux valgus surgery group. Both the outcome score and clinical correction were comparable in the two groups.
CONCLUSION: This study favours bilateral sequential hallux valgus correction (when indicated) without compromising the results, or patient comfort and function.

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References

1. Coughlin MJ, Saltzman CL, Nunley JA II. Angular measurements in the evaluation of hallux valgus deformities: a report of the ad hoc committee of the American Orthopaedic Foot and Ankle Society on angular measurements. Foot Ankle Int 2002;23:68-74.         [ Links ]

2. Kitaoka HB, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux and lesser toes. Foot Ankle Int 1994;15(12):349.         [ Links ]

3. Thordarson DB, Rudicel SA, Ebramzadeh E, Gill LH. Outcome study of hallux valgus surgery - an AOFAS multi-center study. Foot Ankle Int 2001;22(12):956-9.         [ Links ]

 

 

Correspondence:
Dr NP Saragas
P O Box 1153
Highlands North, 2037
Johannesburg
South Africa
Tel: +27 11 485-1974/5; Fax: +27 11 640-5313
Email: saragas@global.co.za

 

 

The content of this article is the sole work of the author. No benefits of any form have been derived from any commercial party related directly or indirectly to the subject of this article.