title: Radiographic Outcomes of Postoperative Taping Following Hallux Valgus Correction.
abstract: BACKGROUND
  Traditionally, hallux valgus operative correction has been accompanied by serial spica taping of the great toe during the postoperative period.
  
  
  METHODS
  We retrospectively reviewed 187 adult patients who underwent proximal first metatarsal osteotomy with a modified McBride procedure in 2008-2009 (n = 83) and 2011-2012 (n = 104). Postoperatively, to maintain the corrected position of the hallux, patients from 2008 through 2009 underwent weekly spica taping, while patients from 2011 through 2012 utilized a toe separator. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured using anteroposterior weight-bearing preoperative, 2-week postoperative non-weight-bearing, and 3-month weight-bearing final follow-up radiographs. A mixed-effects linear regression model identified differences between the treatment groups over time, and a t test compared actual radiographic differences at final follow-up.
  
  
  RESULTS
  The mixed-effects model revealed no significant difference in the HVA over time when comparing patients taped to those not taped at the preoperative (33 ± 6 vs 33 ± 6), 2-week postoperative (10 ± 7 vs 9 ± 6), and 3-month follow-up (14 ± 6 vs 11 ± 7) visits (P = .08). At final follow-up, the HVA was lower for the group that was not taped, but the difference (2.5 degrees) was below the minimal clinically important difference (MCID) (P = .015, 95% CI 0.5-4.5). For IMA, there was improved maintenance of correction over time in the patients that were not taped compared to those taped at the preoperative (15 ± 3 vs 15 ± 3), 2-week postoperative (2 ± 2 vs 3 ± 3), and 3-month follow-up (5 ± 4 vs 7 ± 4) visits (P = .002). At final follow-up, the IMA was lower for the group that was not taped, but the difference (1.7 degrees) was below the MCID (P = .004, 95% CI 0.7-2.9).
  
  
  CONCLUSIONS
  We report no radiographic benefit of postoperative taping after hallux valgus correction. The present study challenges the previous dogma of postoperative spica taping as the protocol is cost and time intensive for the patient and surgeon.
  
  
  METHODS
  Level III, comparative series.
authors.affiliation: Rothman Institute/Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Danielle Y
authors.initials: DY
authors.lastname: Ponzio
authors.affiliation: Rothman Institute/Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: David I
authors.initials: DI
authors.lastname: Pedowitz
authors.affiliation: Rothman Institute/Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Kushagra
authors.initials: K
authors.lastname: Verma
authors.affiliation: Rothman Institute/Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Mitchell G
authors.initials: MG
authors.lastname: Maltenfort
authors.affiliation: Rothman Institute/Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Winters
authors.affiliation: Rothman Institute/Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA steven.raikin@rothmaninstitute.com.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Raikin
mesh_terms: D005260:Female; D006215:Hallux Valgus / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D053832:Surgical Tape
keywords: bunion; hallux valgus; hallux valgus angle; intermetatarsal angle; proximal metatarsal osteotomy; taping