t’s A Small World After All- Surgical Management of Hallux Valgus and Hallux Rigidus: An Email Survey Among Foot and Ankle Orthopedic Surgeons Regarding Their Current Practice

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

Background: Hallux valgus and hallux rigidus are common conditions for which numerous operative interventions have been described in the literature. Various clinical and radiological measurements have been used to help grade severity and to guide treatment. Various clinical and radiological criteria have been suggested to choose one of the numerous techniques in surgical treatment of hallux valgus and rigidus. We hypothesized that the surgeons' professional background will influence that choice depending on age, type and institution of training as well as their orthopaedic cultural orientation. Materials and Methods: A survey was e-mailed to all members of the Israeli Foot and Ankle Orthopaedic Association. Questions were asked regarding respondents' demographics as well as their preferred treatment for 3 separate cases of hallux valgus and hallux rigidus of varying severity. They were specifically asked about type of deformity correction and type of fixation. The responses were collected and statistically analysed. Results: The survey was mailed to all 75 members of the Israeli Orthopaedic Foot and Ankle Association. 58 responses were received with a response rate of 73%. Selected surgical treatments differed as follows: for moderate hallux valgus 60% of the responders chose MIS MICA as the preferred procedure. For severe hallux valgus 45% stated they would fuse the 1st MTPJ (Metatarsophalangeal joint) while 30% would perform MIS (Minimally Invasive Surgery) MICA (Minimally Invasive Chevron Akin). For Hallux rigidus 90% of the responders said they would fuse the joint. Conclusion: The study identifies that in spite of the large number of procedures described in the literature, the vast number of surgeons use only a small number of procedures. The Foot and Ankle specialists tend to perform more modern surgeries such as MICA.