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Demographic characteristic of patients who underwent hallux valgus surgery in a private clinic
Abstracts from the 6th IFFAS Triennial Meeting / Foot and Ankle Surgery 23(S1) (2017) 29–154
B. Swelling subsided postoperatively but postoperative stiffness, lack of toe purchase and range of motion deficits did not change in the course of time. All osteotomies healed. The VAS-FA improved for both groups. Tornique time and operating time were lower and radiation doses higher in Group B. Conclusions: The DMMO resulted in a comparable patient satisfaction and comparable radiological healing compared to WO and appears to be a valid alternative to the WO. http://dx.doi.org/10.1016/j.fas.2017.07.338
250 Comparing outcomes of 1st metatarsophalangeal joint arthrodesis using open and minimally invasive techniques K.K. Dasari ∗ , A. Razik, P. Linardatou Novak, P. Hamilton, A. Sott Epsom & St Helier NHS Trust, UK Introduction: First metatarsophalangeal joint (1st MTPJ) osteoarthritis is a common presentation in the foot and ankle clinic and the prevalence of this condition increases with age. Various open or arthroscopic-assisted techniques are described and reported healing rates vary from 90 to 100%. Methods: We conducted a prospective study of all 1st MTPJ fusions performed open or using minimally invasive surgery (MIS) in a single centre. This took place between 2011 and 2014 with a minimum follow up of 2 years. 29 MIS fusion and 17 open fusion. We assessed patient outcomes and satisfaction using the visual analogue score (VAS) and the Manchester Oxford Foot Questionnaire (MOXFQ). Finally, we also assessed the revision rates. Results: This study covered 46 cases (29 MIS; 17 open; 33 female; 13 male; mean age, 60 years; range, 25 to 77 years). The MOXFQ scores improved from a mean of 50 points to 16 points in MIS and mean of 52 points to 14 points in open surgery at last follow up. The revision rate (MIS 3; 10%, open 1; 6%) was statistically analogous in both groups. Conclusion(s): Patient satisfaction is similar for both techniques for 1st MTPJ Fusion. Radiological union was seen earlier in open technique (14 of 17, 82%) than MIS (9 of 29, 31%) at six weeks follow up. Implications: Conversely, we did not find any significant difference in patient satisfaction or radiological union in the two year follow up., better-quality randomised studies are needed to obtain statistically significant results. http://dx.doi.org/10.1016/j.fas.2017.07.339
251 Clinical and radiological outcomes of correction of hallux valgus without distal lateral soft tissue release (DLSTR) K.K. Dasari ∗ , P. Linardatou Novak, A. Sott Epsom & St Helier NHS Trust, UK Introduction: Distal lateral soft tissue release (DLSTR) is a common procedure that surgeons perform in conjunction with hallux valgus osteotomy correction. Excessive soft tissue procedures may lead to avascular osteonecrosis of the metatarsal head, instability and avascular necrosis. Methods: We are presenting a series of hallux valgus correction without DLSTR performed in a single centre. This took place
83
between January and December 2014 with a minimum follow up of 1.5 years. Using our foot and ankle service database, we identified a cohort of patients (17 patients, 5 bilateral, 22 ft) who had hallux valgus correction. We assessed radiological outcomes using Intermetatarsal Angles (IMA), Hallux Valgus Angle (HVA) and Distal Metatarsal Articulation Angle (DMAA) and patient outcomes using the visual analogue score (VAS) and the Manchester Oxford Foot Questionnaire (MOXFQ). Results: This study included 22 ft (12 female and 5 male; mean age: 50; range: 30–75 years). 19 ft had a SCARF osteotomy, 3 ft had a Chevron osteotomy. 21 out of 22 ft had an Akin osteotomy. IMA improved from a mean of 14◦ (range 9–19◦ ) to 8◦ (range 3–13◦ ). HVA improved from a mean 32◦ (range 19–55◦ ) to 13◦ (range 4–30◦ ). DMAA improved from a mean of 17◦ (range 4–26◦ ) to 9◦ (range 2–19◦ ). The MOXFQ scores improved from a mean of 39 to 5 points and VAS improved from 7 to 2. Conclusion(s): This study shows that very good results can be achieved without performing a lateral release for hallux valgus correction. http://dx.doi.org/10.1016/j.fas.2017.07.340
252 Demographic characteristic of patients who underwent hallux valgus surgery in a private clinic I. Zwinczewski 1,∗ , H. Zwinczewska 2 , B. Jasiewicz 3 1 Non-public Health Care Facility Batory, Krakow, Poland 2 Jagiellonian University Medical College, Poland 3 Jagiellonian University, College of Medicine, Department of Orthopedics and Rehabilitation, Poland
Introduction: Population in most countries is ageing. With an improvement of economic status, the number of surgeries performed in private clinics constantly increases. The aim of the study was to evaluate patients who underwent surgery for hallux valgus or rigidus in a private clinic. Methods: Data of patients operated between 2014 and 2016 were collected and analysed retrospectively, including demographic data, the reason of surgery and severity of deformity. Exclusion criteria: other than only halux surgery, previous operations in this area. Results: In total, 817 patients (96.21% females) were included into the study. The mean age was 56.60yrs ± 10.93; 79% were professionally active, 21% were retired. Majority of patients (68.42%) were diagnosed with a symptomatic hallux valgus and 25.34% with hallux rigidus. The main problem reported by patients before surgery was footwear selection difficulties (77%). Months with the biggest number of surgeries performed were September and January. The worse was right foot and it was operated first in 51.53% cases. The mean pre op HVA angle was 42.43 ± 12.16 and IMA angle was 11.58 ± 2.93. Less than 35% of patients came from the city, where clinic is located. As many as 65.97% had a university degree. Over 70% came from big cities (>100,000 people). Most patients (98.53%) were satisfied with the perioperative care. Conclusions: The vast majority of patients are females, in a perimenopausal period. Most people came from big cities, and they had a severe forefoot deformity. For surgery, patients choose months with, or just after holidays (winter or summer). http://dx.doi.org/10.1016/j.fas.2017.07.341
B. Swelling subsided postoperatively but postoperative stiffness, lack of toe purchase and range of motion deficits did not change in the course of time. All osteotomies healed. The VAS-FA improved for both groups. Tornique time and operating time were lower and radiation doses higher in Group B. Conclusions: The DMMO resulted in a comparable patient satisfaction and comparable radiological healing compared to WO and appears to be a valid alternative to the WO. http://dx.doi.org/10.1016/j.fas.2017.07.338
250 Comparing outcomes of 1st metatarsophalangeal joint arthrodesis using open and minimally invasive techniques K.K. Dasari ∗ , A. Razik, P. Linardatou Novak, P. Hamilton, A. Sott Epsom & St Helier NHS Trust, UK Introduction: First metatarsophalangeal joint (1st MTPJ) osteoarthritis is a common presentation in the foot and ankle clinic and the prevalence of this condition increases with age. Various open or arthroscopic-assisted techniques are described and reported healing rates vary from 90 to 100%. Methods: We conducted a prospective study of all 1st MTPJ fusions performed open or using minimally invasive surgery (MIS) in a single centre. This took place between 2011 and 2014 with a minimum follow up of 2 years. 29 MIS fusion and 17 open fusion. We assessed patient outcomes and satisfaction using the visual analogue score (VAS) and the Manchester Oxford Foot Questionnaire (MOXFQ). Finally, we also assessed the revision rates. Results: This study covered 46 cases (29 MIS; 17 open; 33 female; 13 male; mean age, 60 years; range, 25 to 77 years). The MOXFQ scores improved from a mean of 50 points to 16 points in MIS and mean of 52 points to 14 points in open surgery at last follow up. The revision rate (MIS 3; 10%, open 1; 6%) was statistically analogous in both groups. Conclusion(s): Patient satisfaction is similar for both techniques for 1st MTPJ Fusion. Radiological union was seen earlier in open technique (14 of 17, 82%) than MIS (9 of 29, 31%) at six weeks follow up. Implications: Conversely, we did not find any significant difference in patient satisfaction or radiological union in the two year follow up., better-quality randomised studies are needed to obtain statistically significant results. http://dx.doi.org/10.1016/j.fas.2017.07.339
251 Clinical and radiological outcomes of correction of hallux valgus without distal lateral soft tissue release (DLSTR) K.K. Dasari ∗ , P. Linardatou Novak, A. Sott Epsom & St Helier NHS Trust, UK Introduction: Distal lateral soft tissue release (DLSTR) is a common procedure that surgeons perform in conjunction with hallux valgus osteotomy correction. Excessive soft tissue procedures may lead to avascular osteonecrosis of the metatarsal head, instability and avascular necrosis. Methods: We are presenting a series of hallux valgus correction without DLSTR performed in a single centre. This took place
83
between January and December 2014 with a minimum follow up of 1.5 years. Using our foot and ankle service database, we identified a cohort of patients (17 patients, 5 bilateral, 22 ft) who had hallux valgus correction. We assessed radiological outcomes using Intermetatarsal Angles (IMA), Hallux Valgus Angle (HVA) and Distal Metatarsal Articulation Angle (DMAA) and patient outcomes using the visual analogue score (VAS) and the Manchester Oxford Foot Questionnaire (MOXFQ). Results: This study included 22 ft (12 female and 5 male; mean age: 50; range: 30–75 years). 19 ft had a SCARF osteotomy, 3 ft had a Chevron osteotomy. 21 out of 22 ft had an Akin osteotomy. IMA improved from a mean of 14◦ (range 9–19◦ ) to 8◦ (range 3–13◦ ). HVA improved from a mean 32◦ (range 19–55◦ ) to 13◦ (range 4–30◦ ). DMAA improved from a mean of 17◦ (range 4–26◦ ) to 9◦ (range 2–19◦ ). The MOXFQ scores improved from a mean of 39 to 5 points and VAS improved from 7 to 2. Conclusion(s): This study shows that very good results can be achieved without performing a lateral release for hallux valgus correction. http://dx.doi.org/10.1016/j.fas.2017.07.340
252 Demographic characteristic of patients who underwent hallux valgus surgery in a private clinic I. Zwinczewski 1,∗ , H. Zwinczewska 2 , B. Jasiewicz 3 1 Non-public Health Care Facility Batory, Krakow, Poland 2 Jagiellonian University Medical College, Poland 3 Jagiellonian University, College of Medicine, Department of Orthopedics and Rehabilitation, Poland
Introduction: Population in most countries is ageing. With an improvement of economic status, the number of surgeries performed in private clinics constantly increases. The aim of the study was to evaluate patients who underwent surgery for hallux valgus or rigidus in a private clinic. Methods: Data of patients operated between 2014 and 2016 were collected and analysed retrospectively, including demographic data, the reason of surgery and severity of deformity. Exclusion criteria: other than only halux surgery, previous operations in this area. Results: In total, 817 patients (96.21% females) were included into the study. The mean age was 56.60yrs ± 10.93; 79% were professionally active, 21% were retired. Majority of patients (68.42%) were diagnosed with a symptomatic hallux valgus and 25.34% with hallux rigidus. The main problem reported by patients before surgery was footwear selection difficulties (77%). Months with the biggest number of surgeries performed were September and January. The worse was right foot and it was operated first in 51.53% cases. The mean pre op HVA angle was 42.43 ± 12.16 and IMA angle was 11.58 ± 2.93. Less than 35% of patients came from the city, where clinic is located. As many as 65.97% had a university degree. Over 70% came from big cities (>100,000 people). Most patients (98.53%) were satisfied with the perioperative care. Conclusions: The vast majority of patients are females, in a perimenopausal period. Most people came from big cities, and they had a severe forefoot deformity. For surgery, patients choose months with, or just after holidays (winter or summer). http://dx.doi.org/10.1016/j.fas.2017.07.341