Abstract
Background: Since 2003 we have offered correction of bilateral hallux valgus to suitable patients as a daycase but there is nothing in the literature to support this as safe practice. Two published series support unilateral hallux valgus surgery as a daycase. We prospectively evaluated 30 bilateral daycase patients assessing complications and overall satisfaction rating.
Methods: The study group comprised 15 bilateral Scarf osteotomies, 9 bilateral Chevron osteotomies, 4 unilateral Scarf plus unilateral Chevron osteotomies, 1 bilateral 1st MTP joint fusion and 1 bilateral Lapidus procedure. All surgery was performed as a daycase under GA and ankle block. All patients were evaluated clinically and radiologically pre & post-operatively and had AOFAS scores measured. 21 patients were telephoned on the 3rd post-operative day to document their pain scores (0–10) and all patients responded to a patient satisfaction questionnaire at their discharge around 4.5 months.
Results: 18 of the 21 patients interviewed on day 3 had mild pain (0–4) as their maximum pain score. 3 reported problems (2 of pain and 1 of poor mobility). There was one unilateral superficial wound infection which required oral antibiotics. No other patients required to call or attend their GP nor attend A& E. The mean overall patient satisfation rating (0–10) was 8.8 (median 9). If having similar repeat surgery 4 of the 30 patients (13%) would prefer an overnight stay. The reasons given by these 4 patients were: pain (1), poor mobility (1), a desire to be looked after by the nursing staff (2).
Conclusions: Bilateral hallux valgus surgery can be performed safely as a daycase and with acceptable levels of patient satisfaction. It does not appear to result in an increased complication rate. To our knowledge this has not been previously documented in the literature.
Correspondence should be addressed to the Honorary Secretary, BOFSS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
