BACKGROUND: During hallux valgus surgery, the abnormal position of the first metatarsal bone relative to the sesamoids is addressed. Our study aimed to investigate the influence of postoperative tibial sesamoid position (TSP) on functional outcome and patient satisfaction after hallux valgus surgery. METHODS: Between February 2007 and November 2011, 250 patients who underwent hallux valgus surgery at our tertiary hospital were followed for 2 years after surgery. They were categorized into 2 groups based on Hardy and Clapham's TSP classification, recorded on postoperative weight-bearing anteroposterior (AP) radiographs: (1) normal (grades I-IV) and (2) outliers (grades V-VII). RESULTS: The mode TSP improved from grade VII preoperatively to grade IV postoperatively (P < .001). The visual analog scale for pain was 1 (95% CI 0, 1) point better in the normal group compared to the outlier group at 2 years after surgery (P = .050), whereas the American Orthopaedic Foot & Ankle Society Hallux Metatarsophalangeal-Interphalangeal Scale was 6 (95% CI 2, 11) points higher in the normal group (P = .009). Patients in the outlier group were also more likely to be dissatisfied with the surgery performed when compared to the normal group (OR 3.881, 95% CI 1.689, 8.920, P = .001). CONCLUSION: We recommend correcting the TSP to grade of IV or less to improve functional outcome and satisfaction after hallux valgus surgery. LEVEL OF EVIDENCE: Level III, retrospective comparative series.
BACKGROUND: During hallux valgus surgery, the abnormal position of the first metatarsal bone relative to the sesamoids is addressed. Our study aimed to investigate the influence of postoperative tibial sesamoid position (TSP) on functional outcome and patient satisfaction after hallux valgus surgery. METHODS: Between February 2007 and November 2011, 250 patients who underwent hallux valgus surgery at our tertiary hospital were followed for 2 years after surgery. They were categorized into 2 groups based on Hardy and Clapham's TSP classification, recorded on postoperative weight-bearing anteroposterior (AP) radiographs: (1) normal (grades I-IV) and (2) outliers (grades V-VII). RESULTS: The mode TSP improved from grade VII preoperatively to grade IV postoperatively (P < .001). The visual analog scale for pain was 1 (95% CI 0, 1) point better in the normal group compared to the outlier group at 2 years after surgery (P = .050), whereas the American Orthopaedic Foot & Ankle Society Hallux Metatarsophalangeal-Interphalangeal Scale was 6 (95% CI 2, 11) points higher in the normal group (P = .009). Patients in the outlier group were also more likely to be dissatisfied with the surgery performed when compared to the normal group (OR 3.881, 95% CI 1.689, 8.920, P = .001). CONCLUSION: We recommend correcting the TSP to grade of IV or less to improve functional outcome and satisfaction after hallux valgus surgery. LEVEL OF EVIDENCE: Level III, retrospective comparative series.
Authors: Jorge Javier Del Vecchio; Mauricio Esteban Ghioldi; Lucas Nicolás Chemes; Eric Daniel Dealbera; Julieta Brue; Miki Dalmau-Pastor Journal: Int Orthop Date: 2021-08-04 Impact factor: 3.075
Authors: Alexandre Leme Godoy-Santos; Alessio Bernasconi; Marcelo Bordalo-Rodrigues; François Lintz; Carlos Felipe Teixeira Lôbo; Cesar de Cesar Netto Journal: Radiol Bras Date: 2021 May-Jun
Authors: Jeremy Y Chan; Naudereh Noori; Stephanie Chen; Glenn B Pfeffer; Timothy P Charlton; David B Thordarson Journal: Foot Ankle Orthop Date: 2020-10-14