title: Subjective versus objective assessment in early clinical outcome of modified Lapidus procedure for hallux valgus deformity.
abstract: BACKGROUND
  Studies have assessed the outcome of hallux valgus surgeries based on subjective questionnaires, usually the American Orthopaedic Foot and Ankle Society Score, and radiographic results reporting good to excellent outcome at 6-12 months postoperatively. However, contrasting results were reported by gait studies at 12-24 months postoperatively. In a previous study, we found nine gait parameters which can describe the altered gait in hallux valgus deformity. This study aimed, to assess the outcome of modified Lapidus at 6 months postoperatively, using gait assessment method, to determine if the nine specified gait parameters effectively relates with the clinical scores and the radiological results or add information missed by these commonly used clinical assessments.
  
  
  METHODS
  We assessed 21 participants including 11 controls and 10 patients with moderate to severe hallux valgus deformity. The patient group was followed 6 months postoperatively. The ambulatory gait assessment was performed utilizing pressure insoles and inertial sensors. Clinical assessment includes foot and ankle questionnaires along with radiographic results. Comparison was made using non parametric tests, P<0.05.
  
  
  RESULTS
  Altered gait patterns, similar to the preoperative outcome, persisted at 6 months postoperatively when compared to controls. The foot and ankle ability measure score showed an outcome comparable to the gait results. In contrast, the American Orthopaedic Foot and Ankle Society Score and radiographic results showed significant improvement.
  
  
  CONCLUSIONS
  Study supports the reliability of nine defined gait parameters in assessing the outcome of hallux valgus surgeries. The existing clinical assessment overestimates the functional outcome at the early postoperative phase.
authors.affiliation: Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Department of Orthopaedic Surgery and Traumatology, Pierre-Decker 4, CH-1011 Lausanne, Switzerland. Electronic address: Swati.Chopra@chuv.ch.
authors.forename: S
authors.initials: S
authors.lastname: Chopra
authors.affiliation: Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Department of Orthopaedic Surgery and Traumatology, Pierre-Decker 4, CH-1011 Lausanne, Switzerland. Electronic address: Kevin.Moerenhout@chuv.ch.
authors.forename: K
authors.initials: K
authors.lastname: Moerenhout
authors.affiliation: Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Department of Orthopaedic Surgery and Traumatology, Pierre-Decker 4, CH-1011 Lausanne, Switzerland. Electronic address: Xavier.Crevoisier@chuv.ch.
authors.forename: X
authors.initials: X
authors.lastname: Crevoisier
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005528:Foot / Q000503:physiopathology* / Q000601:surgery; D005684:Gait; D006214:Hallux / Q000503:physiopathology* / Q000601:surgery; D006215:Hallux Valgus / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D026741:Physical Therapy Modalities; D011184:Postoperative Period; D011859:Radiography; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013639:Tarsal Bones / Q000000981:diagnostic imaging
keywords: AOFAS; Bunion; FAAM; Gait assessment; Radiographic evaluation