Surgical treatment of hallux valgus and forefoot deformities in Sweden: a population-based study.
BACKGROUND
Although surgical correction for hallux valgus and other toe deformities is one of the most common procedures in foot surgery, its incidence in the general population is not well-known.


METHODS
The study population comprised patients living in Sweden of a varied age group and both sexes who underwent forefoot surgery. We identified all inpatient cases from 1997 to 2000 and all ambulatory cases in 2000 registered in the National Swedish Patient Register (NSPR). Further, clinical data for the surgical treatment of hallux valgus deformity were extracted from medical records in patients treated in a geographically defined region (Stockholm).


RESULTS
In total, 6956 patients with surgically treated forefoot deformities were identified from the adult population, equivalent to a cumulative incidence of 0.8 procedures per 1000 inhabitants for the whole analyzed group. There were regional variations and significant sex differences. The age distribution in both sexes was characterized by a peak in the fifth decade. Forefoot surgery was statistically more frequently performed in private clinics than in public hospitals (p < 0.001). Hallux valgus surgery was by far the most common procedure regarding forefoot surgery.


CONCLUSIONS
The prevalence of forefoot- and hallux valgus surgery was not evenly distributed in the six major regions in Sweden. It is more common in urban than in rural regions. Furthermore, forefoot surgery is performed more frequently in private clinics than in community hospitals despite common financial sources.
Saro
Carlos
C
Karolinska Institute at Karolinska University Hospital, CLINTEC, Division of Orthopaedics, Hälsovägen, Stockholm, 141 86, Sweden. carlos.saro@ki.se
Bengtsson
Ann-Sophie
AS
Lindgren
Urban
U
Adami
Johanna
J
Blomqvist
Paul
P
Felländer-Tsai
Li
L
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D006215:Hallux Valgus / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000706:statistics & numerical data*; D015995:Prevalence; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology