title: Impact of podiatry resident experience level in hallux valgus surgery on postoperative outcomes.
abstract: BACKGROUND
  Despite modern advancements in transosseous fixation and operative technique, hallux valgus (i.e., bunion) surgery is still associated with a higher than usual amount of patient dissatisfaction and is generally recognized as a complex and nuanced procedure requiring precise osseous and capsulotendon balancing. It stands to reason then that familiarity and skill level of trainee surgeons might impact surgical outcomes in this surgery. The aim of this study was to determine whether podiatry resident experience level influences midterm outcomes in hallux valgus surgery (HVS).
  
  
  METHODS
  Consecutive adults who underwent isolated HVS via distal metatarsal osteotomy at a single US metropolitan teaching hospital from January 2004 to January 2009 were contacted and asked to complete a validated outcome measure of foot health (Manchester-Oxford Foot Questionnaire) regarding their operated foot. Resident experience level was quantified using the surgical logs for the primary resident of record at the time of each case. Associations were assessed using linear and logistic regression analyses.
  
  
  RESULTS
  A total of 102 adult patients (n = 102 feet) agreed to participate with a mean age of 46.8 years (standard deviation 13.1, range 18-71) and average length of follow-up 6.2 y (standard deviation 1.4, range 3.6-8.6). Level of trainee experience was not associated with postoperative outcomes in either the univariate (odds ratio 0.99 [95% confidence interval, 0.98-1.01], P = 0.827) or multivariate analyses (odds ratio 1.00 [95% confidence interval, 0.97-1.02], P = 0.907).
  
  
  CONCLUSIONS
  We conclude that podiatry resident level of experience in HVS does not contribute appreciably to postoperative clinical outcomes.
authors.affiliation: Department of Surgery, Advocate Illinois Masonic Medical Center, Chicago, Illinois; Center for Lower Extremity Ambulatory Research (CLEAR), Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois. Electronic address: adam.e.fleischer@gmail.com.
authors.forename: Adam E
authors.initials: AE
authors.lastname: Fleischer
authors.affiliation: Department of Surgery, Advocate Illinois Masonic Medical Center, Chicago, Illinois; Center for Lower Extremity Ambulatory Research (CLEAR), Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois.
authors.forename: Martin C
authors.initials: MC
authors.lastname: Yorath
authors.affiliation: Center for Lower Extremity Ambulatory Research (CLEAR), Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Joseph
authors.affiliation: Center for Lower Extremity Ambulatory Research (CLEAR), Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois.
authors.forename: Adam
authors.initials: A
authors.lastname: Baron
authors.affiliation: Center for Lower Extremity Ambulatory Research (CLEAR), Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois.
authors.forename: Thomas
authors.initials: T
authors.lastname: Nordquist
authors.affiliation: Department of Surgery, Advocate Illinois Masonic Medical Center, Chicago, Illinois.
authors.forename: Braden J
authors.initials: BJ
authors.lastname: Moore
authors.affiliation: Department of Surgery, Advocate Illinois Masonic Medical Center, Chicago, Illinois.
authors.forename: Richmond C O
authors.initials: RC
authors.lastname: Robinson
authors.affiliation: Department of Surgery, Advocate Illinois Masonic Medical Center, Chicago, Illinois.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Reilly
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011032:Podiatry / Q000193:education / Q000592:standards*; D016896:Treatment Outcome
keywords: Foot surgery; Outcome; Podiatric surgery; Podiatry; Resident experience; Surgery; Trainee experience
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