Background: To assess the cosmetic advantage of costotomy at the angle of the ribs on the convexity of a curve in the management of Adolescent Idiopathic scoliosis. Whilst modem segmental correction produces gratifying improvement in Cobb-angle and, to some extent rotation, rib asymmetry often remains as a concern for patients. Performing costotomy at the angle of the rib at the same time as corrective surgery can improve the cosmetic appearance significantly. It avoids any further scars or surgery, and is associated with minimal complications, the main one being pneumothorax and the requirement of a chest drain.

Methods: Retrospective review of 50 patients. This has been a standard practice and this presentation reports on 50 patients treated in Preston with a variety of corrective devices; we have assessed results radiologically, with cosmetic acceptability by the patient and surface topographical analysis.

Results: Significant improvement occurs at the time of costotomy as the ribs drop from their arched position after the coronal deformity has been improved

Conclusion: The addition of costotomy at the time of primary surgery for Adolescent Idiopathic Scoliosis leads to minimal complications. Significant improvement occurs at the time of costotomy as the ribs drop from their arched position after the coronal deformity has been improved. This is maintained in the post-operative period by moulding of the brace.

Aims Pedobarography has improved the understanding of load transmission in hallux valgus. The aim of this study is to evaluate Pedobarography in Modified McBride procedure which transfers the deforming of adductor hallucis into a correcting force on the first metatarsal neck. Material and Methods Nineteen patients with 27 feet in total who underwent this procedure were included in this study. Average age was 49 yrs (range 28 – 73). Average follow up was 7 months (range 6–14 months). Pedobarography was performed before and after the operation using EMED SFX 6 system to record the contact area, total force, peak pressures and contact time for total foot, great toe and areas of foot medial to gait line. Results Pedobarographic measurements showed a statistically significant improvement in the contact area of the great toe 7.4 cm preoperatively to 8.7 cm postoperatively (17.5%, p < 0.001) and reduction in peak pressures of the great toe from 67.5 N/cm to 48 N/cm (29%, p < 0.001) and the total foot from 89 N/cm to 82 N/cm (8% p < 0.05). Conclusion We conclude that Pedobarography demonstrates the normalisation of forces in the foot following Modified McBride Procedure.