Abstract
To compare hallux valgus surgery performed by orthopaedic surgeons and podiatrists within the same Health Authority, a consecutive series of 50 patients operated on within the orthopaedic department for hallux valgus was compared with a group operated on by the podiatry surgeons within the same time period.
This retrospective study was performed by analysis of the case notes and radiographs. Data was collected on patient age, sex, comorbidity, anaesthetic, surgery, surgeon grade, post-operative rehabilitation and complications. Pre and post operative hallux valgus and intermetatarsal angles were measured.
Patient demographics showed no significant difference between the 2 groups. All but one patient in the orthopaedic group had a general anaesthetic whilst regional anaesthesia (ankle block) performed by the operating surgeon was used in all cases in the podiatry group.
There were 4 different operations in the orthopaedic group (Mitchells, Chevron, bunionectomy, Wilsons) compared with 2 in the podiatry group (Scarf, Kellers). Pre-operative radiological measurements revealed comparable groups with the correction obtained better in the podiatry group (HV angle 15° vs 10°; IM angle 7° vs 4°).
There were 13 complications in the podiatry group compared with 8 in the orthopaedic group.
9 patients in the podiatry group underwent re-operation to remove metalwork whilst no patients in the orthopaedic group required further surgery.
Within our region, orthopaedic and podiatry surgeons operate on the same type of patients with hallux valgus in respect to age, sex, comorbidity and radiological abnormality. There is marked difference in the anaesthetic techniques used. Correction obtained in the podiatry group was slightly better but at the expense of a higher complication and re-operation rate.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom
