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Orthopedic Research Online Journal

Investigating How the Degree of Radiological Correction Corresponds to Patient Reported Outcomes in Scarf Osteotomy

  • Open or Close Karam Ahmad1* and Anand Pillai2

    1Imperial College NHS Trust, UK

    2University Hospital of South Manchester, UK

    *Corresponding author: Karam Ahmad, Imperial College NHS Trust, Praed St, London, UK, Email:

Submission: October 02, 2017;Published: June 13, 2018

DOI: 10.31031/OPROJ.2018.03.000557

ISSN: 2576-8875
Volume3 Issue2


Background: Patient-reported outcome measures (PROMs) are important in modern healthcare systems. Previous studies on PROMs in halluxvalgus (HV) surgery show positive outcomes. We investigated the relationship between radiological correction and PROMs in hallux-valgus surgery.

Patients and methods: A total of 350 patients underwent foot and ankle surgery and signed up to the PROMS 2.0 scheme. 97 patients provided complete pre-operative and post-operative data of which 40 had undergone scarf osteotomy and fitted in to selection criteria. Data collection was performed using the Manchester-Oxford Foot Questionnaire (MOxFQ). Radiological measurements (HVA-hallux-valgus angle and IMTA- Intermetatarsal angle) were calculated by two independent blinded foot and ankle surgeons on PACS. A comparative analysis was done between degree of radiological correction and pre-/post-op PROMs. Statistical tests were carried out using IBM-SPSS Statistics (V19).

Results: 40 patients included with female predominance, equal side distribution and no bilateral procedures. Average age at time of surgery- 60.7 years (Range 29-88). Mean pre-op MOxFQ=52.9 (12.0-100.0), mean post-op MOxFQ=23.6 (0-91.3) and mean improvement in MOxFQ=29.4 (-18.7-73.3) p<0.05. HVA- average pre-op angle=34.97° (13.20°-57.00), average post-op angle=15.01° (2.00-39.10). Mean HV correction angle=19.97(3.20-47.50). There was statistically significant correlation between pre-op/post-op HVA measurements and pre-op/post-op PROMS values respectively (p<0.05). There was direct correlation between HVA correction and improvement in PROMS

For IMTA, average pre-op angle=17.38° (10.40-27.60), average post-op angle=12.09° (6.00-21.10). Mean IMTA Correction=5.29(0.20-15.80). There was statistically significant correlation between pre-op/post-op IMTA measurements and pre-op/post-op PROMS values respectively (p< 0.05). There was direct correlation between IMTA correction and improvement in PROMS.

Conclusion: Hallux-valgus surgery is an effective procedure with high PROMS. There is a positive correlation between PROMS and degree of deformity. As HVA/IMTA increase, PROMs decrease. As HVA and IMTA correction increases, PROMs improves. Better surgical correction leads to better PROMS.

Keywords: PROMs; Foot and ankle; Hallux valgus; Scarf osteotomy; Hallux valgus angle; Inter-metatarsal angle

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