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Background
Hallux valgus and hallux rigidus are common foot conditions that lead to a deterioration in health status. Patients with significant pain or deformity from these conditions frequently resort to surgery. In this project, the foot health status of patients with hallux valgus and hallux rigidus presenting to foot surgeons in Australia was compared.
Methods
Foot health status was measured in 120 participants using the Foot Health Status Questionnaire (FHSQ), a validated 0 - 100 point health status instrument. All participants had presented for surgical advice regarding hallux valgus / rigidus. The mean age of participants was 48.0 years (SD 14.3, range 19 - 79).
Results
In the sample, 68% of participants were diagnosed with hallux valgus and 32% with hallux rigidus. Participants with hallux rigidus had greater levels of pain and functional limitation compared with hallux valgus. The mean difference for pain was 13.8 points (95% CI 4.6 to 22.9) and the mean difference for function was 15.0 points (95% CI 5.3 to 24.7). Both conditions result in similarly negative levels of impact on shoe fit and overall foot health.
Conclusions
This study found measurable differences in foot health status between hallux valgus and hallux rigidus in participants presenting for surgical consultation. While both appear to have a negative impact on health status, hallux rigidus has a more significant impact.
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Re: Health-related quality of life in people with hallux valgus and hallux rigidus
Well..... they don't define either hallux rigidus or hallux valgus (I haven't read the whole paper). I'm willing to bet though, that they are dealing with hallux limitus, in which the 1st MTPJ is painful, opposed to a true hallux rigidus which is not.
Re: Health-related quality of life in people with hallux valgus and hallux rigidus
Perhaps, but assuming all three of the authors don't know Latin might be a stretch. And "greater levels of . . functional limitation" (than hallux valgus) seems pretty clear. We all know what fusion does to function.
I think fusion is done just because it's easy to do. And the bunion never returns. Because so many do it, especially in public health countries, it's not substandard.
Re: Health-related quality of life in people with hallux valgus and hallux rigidus
Impact of hallux valgus severity on general and foot-specific health-related quality of life.
Menz HB, Roddy E, Thomas E, Croft PR. Arthritis Care Res (Hoboken). 2010 Nov 15.
Quote:
OBJECTIVES: (i) to explore the prevalence of and factors associated with hallux valgus, and (ii) to assess the impact of hallux valgus severity on general and foot-specific health-related quality of life (HRQOL) in older people.
METHODS: People aged 56 years and over who participated in the six year follow-up of the North Staffordshire Osteoarthritis Project (n=2,831) completed a survey which included the Short Form 36 (SF-36) and the Manchester Foot Pain and Disability Index (FPDI). Self-reported hallux valgus severity was assessed using a validated instrument. Comparisons of SF-36 and FPDI scores were made across five severity grades of hallux valgus.
RESULTS: Hallux valgus was present in 36.3% of the study population and was associated with female sex, older age, and pain in other bodily regions. There was a progressive reduction in all SF-36 component scores as the severity of hallux valgus increased; an association that remained after adjusting for age, sex, education and body mass index. After also adjusting for pain in the back, hip, knee and foot, the strength of these associations diminished, but hallux valgus severity remained significantly associated with reduced physical function, bodily pain, general health, social function and mental health subscale scores. Amongst participants with foot pain, increasing hallux valgus severity was also significantly associated with greater impairment on the pain and function subscales of the FPDI after adjusting for age, sex and body mass index.
CONCLUSIONS: There is a progressive reduction in both general and foot-specific HRQOL with increasing severity of hallux valgus deformity.
BACKGROUND: : Hallux valgus is a common chronic condition affecting up to a third of the population. Progressive disruption to the complex anatomy of the first ray involving metatarsal, sesamoids and hallux impose both structural and functional alteration to the foot which underpin the secondary pathologies associated with this condition. It is common for patients to seek correction of the deformity in order to alleviate pain and improve footwear tolerance. Surgical intervention remains the only viable means to restore osseous alignments. To date there remains no universally accepted standards for procedure selection.
METHODS: : A total of 179 consecutive participants were recruited into the study. Ethical approval was obtained and all participants consented to participate in the study, in accordance with the Helsinki Declaration. All patients attending the Department of Podiatric Surgery, between July 2004 and October 2007 for the surgical management of hallux valgus were invited to complete a Foot Health Status Questionnaire. Pre-operative data collection on all participants was undertaken on the day of admission, using the validated Foot Health Status Questionnaire measurement tool as with previous studies.
RESULTS: : A total of 179 complete data sets were recorded in this longitudinal study with an average participant age of 49.4 years (SD 14.5). The group comprised 164 females and 15 males. The mean days for administration of the Foot Health Status Questionnaire post operative follow up was 1045 days (149 weeks or 2.9 years). The results demonstrated that within all four foot specific domains, the minimal important differences were achieved by the majority of the group. Meanwhile, in domains relating to general health, physical activity, vigour and social capacity, the majority of participants failed to attain the calculated minimal important difference (94 [53%], 96 [54%], 93 [52%], 93 [52%], respectively).
CONCLUSIONS: : The authors have presented for the first time minimal important difference for all eight domains for the Foot Health Status Questionnaire quality of life tool in respect to hallux valgus surgery. Results demonstrate that surgical correction of hallux valgus undertaken under local anaesthetic as a Day Case procedure is an effective intervention directly benefiting patients by reducing perceived foot pain, improving foot function and general foot health for the majority of patients.
Health-related quality of life in people with hallux valgus and hallux rigidus
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