Influence of Hindfoot Malalignment on Hallux Valgus Operative Outcomes.
BACKGROUND
Hindfoot deformity has been described as a risk factor for poor hallux valgus (HV) surgery outcomes. However, there has been no study that demonstrates it. The purpose of this investigation was to evaluate the influence of hindfoot misalignment in HV surgery results.


METHODS
All patients operated on for HV during 2010 and 2011 at 3 university hospitals were included. The preoperative and 2-year postoperative radiologic data included the HV and the intermetatarsal (IM) angles, the naviculocuboid overlap (NC), the talonavicular coverage (TN) angle, the talus-first metatarsal (T-1MT) angle, as well as the calcaneal pitch (CP) angle. Additionally, the Short Form-36 questionnaire version 2.0 (SF-36) and the American Orthopaedic Foot & Ankle Society (AOFAS) score, satisfaction and recurrence were also analyzed. A total of 207 met the inclusion criteria. There were 26 patients (12.6%) who could not be assessed at the 2-year follow-up. Patients were allocated to a varus, normal, or a valgus hindfoot tertile using the values for the CP, NC, TN, and T-1MT angles.


RESULTS
No significant differences (P > .05) were found between the groups when the HV or IM angles, AOFAS, SF-36 Mental Composite Scale, SF-36 Physical Composite Scale, or satisfaction were compared. Similarly, no significant and strong correlations were observed (P > .05, ρ < 0.3) between any of the mentioned hindfoot measures and the outcomes scales.


CONCLUSIONS
No influence of hindfoot misalignment on HV surgery outcomes was found in the present study in terms of correction, pain, function, satisfaction, or quality of life. Patients with hindfoot misalignment did not obtain worse outcomes in HV surgery.


METHODS
Level II, prognostic, comparative study.
Orthopedic Department, Hospital del Mar. Universitat Autónoma de Barcelona, Spain.
Alberto
A
Ginés-Cespedosa
Orthopedic Department, Hospital del Mar. Universitat Autónoma de Barcelona, Spain dperezprieto@parcdesalutmar.cat.
Daniel
D
Pérez-Prieto
Orthopedic Department, Hospital Vall d'Hebron. Barcelona, Spain.
David
D
Muñetón
Orthopedic Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Gemma
G
González-Lucena
Orthopedic Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Angelica
A
Millán
Orthopedic Department, Hospital del Mar. Universitat Autónoma de Barcelona, Spain.
Santiago
S
de Zabala
Orthopedic Department, Hospital Vall d'Hebron. Barcelona, Spain.
Rosa
R
Busquets
D000368:Aged; D005260:Female; D005528:Foot / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome
forefoot disorders; hallux disorders; misalingment; outcome studies