On-line version ISSN 2309-8309
SA orthop. j. vol.8 n.1 Pretoria Jan. 2009
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
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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