Shared Decision Making in Hallux Valgus Surgery: A Prospective Observational Study - Summary by Liv Harley Street Hospital
Bunion Surgery London

Shared Decision Making in Hallux Valgus Surgery: A Prospective Observational Study – Summary by Liv Harley Street Hospital

Patient-physician communication has the potential to improve outcomes and satisfaction through the shared decision-making process (SDM). This study aims to assess the relationship between perception of SDM and demographic, clinical, and patient-reported outcomes in patients undergoing Hallux Valgus (HV) correction. A prospective analysis of 306 patients scheduled for HV surgery was completed. The CollaboRATE score was used to measure SDM. Multivariable linear regression model was used to assess…

Biomechanical model of minimally invasive hallux valgus surgery - Summary by Liv Harley Street Hospital
Bunion Surgery London

Biomechanical model of minimally invasive hallux valgus surgery – Summary by Liv Harley Street Hospital

Hallux valgus is a common foot deformity characterized by outward tilting and twisting of the big toe, often accompanied by a medial prominence at the base. Minimally invasive surgical techniques are widely utilized for treating metatarsus adductus due to their advantages of smaller incisions, faster recovery, and early weight-bearing. However, due to individual variations and limited sample size, the biomechanical effects of different Kirschner wire fixation methods and the underlying…

Analysis of Factors Influencing Corrective Power of Akin's Osteotomy in 2D Plain Radiographs: What to Consider to Obtain Good Correction in Hallux Valgus Surgery - Summary by Liv Harley Street Hospital
Bunion Surgery London

Analysis of Factors Influencing Corrective Power of Akin’s Osteotomy in 2D Plain Radiographs: What to Consider to Obtain Good Correction in Hallux Valgus Surgery – Summary by Liv Harley Street Hospital

Background/Objectives: Akin osteotomy, in the context of corrective surgery for hallux valgus, is an effective tool available to surgeons. However, few studies have thoroughly investigated the anatomical and technical characteristics to be considered in order to perform an optimal osteotomy. This cross-sectional observational study aims to identify the ideal site for performing Akin osteotomy and to identify the factors that influence its corrective power. Methods: To this end, an analysis was…

Postoperative Opioid Consumption Following Hallux Valgus and Rigidus Surgery: A Guide to Postoperative Prescription Writing - Summary by Liv Harley Street Hospital
Bunion Surgery London

Postoperative Opioid Consumption Following Hallux Valgus and Rigidus Surgery: A Guide to Postoperative Prescription Writing – Summary by Liv Harley Street Hospital

Prescribing postoperative pain medications is essential to foot and ankle surgery; however, prescribing an amount that results in an excess of pills has shown to lead to opioid abuse. The opioid epidemic has forced surgeons to analyze how we manage postoperative pain with a goal to prescribe the optimal number of pills that will reduce a patient’s pain while limiting the amount that is left over. The purpose of this study was to develop a guideline for prescribing postoperative pain medication…

Plantar compartment block for hallux valgus surgery: a proof-of-concept anatomic and clinical study - Summary by Liv Harley Street Hospital
Bunion Surgery London

Plantar compartment block for hallux valgus surgery: a proof-of-concept anatomic and clinical study – Summary by Liv Harley Street Hospital

CONCLUSIONS: This anatomic description of the ultrasound-guided plantar compartment block reported the injection area to target the medial and lateral plantar nerves with 5 mL of local anesthetic. Normal walking without assistance is attained rapidly with this regional anesthesia technique, and the time to request postoperative analgesia after hallux valgus surgery is long.

The Learning Curve in Hallux Valgus Surgery - Summary by Liv Harley Street Hospital
Bunion Surgery London

The Learning Curve in Hallux Valgus Surgery – Summary by Liv Harley Street Hospital

For any surgical technique, the learning curve is the number of times a particular procedure must be undertaken in order to complete it repeatedly with high accuracy and proficiency. Scientifically, a difficult task to master is represented by a flat learning curve, as the steep portion of the learning curve would correlate with rapid learning. Today, there’s more literature on the learning curve of percutaneous HV surgery than on any other procedure in foot and ankle surgery. Due to the lack of…

Early Radiological Outcome of Hallux Valgus Corrective Surgery With an Intramedullary Plate: A Single-Center Case Series - Summary by Liv Harley Street Hospital
Bunion Surgery London

Early Radiological Outcome of Hallux Valgus Corrective Surgery With an Intramedullary Plate: A Single-Center Case Series – Summary by Liv Harley Street Hospital

CONCLUSION: Mini-open hallux valgus surgery using an intramedullary plate is a safe and effective technique that can lead to significant improvement in pain and function for mild to moderate hallux valgus. The modified placement of the plate into the medullary canal allows for a smaller incision while providing correction of the hallux valgus deformity.

Comparison of an Opioid-Free Multimodal Pain Regimen to an Opioid-Containing Regimen in Elective, Outpatient, Bunion, and Forefoot Surgery - Summary by Liv Harley Street Hospital
Bunion Surgery London

Comparison of an Opioid-Free Multimodal Pain Regimen to an Opioid-Containing Regimen in Elective, Outpatient, Bunion, and Forefoot Surgery – Summary by Liv Harley Street Hospital

BackgroundMultimodal, opioid-free regimens for postoperative pain have been increasing in popularity due to concerns regarding the current opioid crisis. Despite their increased popularity, there is limited evidence regarding the effectiveness of these regimens for outpatient forefoot procedures. This study looks to compare a multimodal, opioid-free pain control regimen to a historical opioid regimen in patients undergoing elective, outpatient forefoot procedures.MethodsData were collected…

Epidemiology of hallux valgus surgery in Italy: A nationwide study from 2001 to 2016 - Summary by Liv Harley Street Hospital
Bunion Surgery London

Epidemiology of hallux valgus surgery in Italy: A nationwide study from 2001 to 2016 – Summary by Liv Harley Street Hospital

CONCLUSIONS: The socio-economic burden of hallux valgus surgery in Italy is relevant. The incidence of hallux valgus surgery has progressively increased between 2001 and 2012 and decreased from 2012 to 2016. A geographically unequal distribution of procedures between the three Italian macroregions was pointed out. Migratory flows of patients from the South to the North for undergoing the procedure were observed.

Minimally-Invasive Surgery for Hallux Valgus Correction: Which Techniques Do We Talk About? - Summary by Liv Harley Street Hospital
Bunion Surgery London

Minimally-Invasive Surgery for Hallux Valgus Correction: Which Techniques Do We Talk About? – Summary by Liv Harley Street Hospital

Minimal-invasive surgery (MIS) has gone through a fast and successful evolution in the last decade. First-generation and second-generation MIS techniques introduced the concept of percutaneous surgery. Third-generation MIS techniques made it a reliable option for surgeon at the end of their learning curve. Surgeons may benefit from weight-bearing computed tomographic scan for their planning and follow-up.

Double osteotomy in recurrence cases with distal metatarsal articular angle increase after hallux valgus distal surgery - Summary by Liv Harley Street Hospital
Bunion Surgery London

Double osteotomy in recurrence cases with distal metatarsal articular angle increase after hallux valgus distal surgery – Summary by Liv Harley Street Hospital

CONCLUSION: The combination of distal closed wedge and proximal open wedge osteotomies for HV recurrence seems to be an effective surgical technique for correction of the deformity. Plate and screw fixation can increase the rate of bone union and accelerate postoperative mobilization of the patients. Further large-scale, long-term studies are needed to provide more comprehensive findings on the effectiveness of HV surgery and elucidate the effects of postoperative rehabilitation processes on…