title: Tibial Sesamoid Position Influence on Functional Outcome and Satisfaction After Hallux Valgus Surgery.
abstract: BACKGROUND
  During hallux valgus surgery, the abnormal position of the first metatarsal bone relative to the sesamoids is addressed. Our study aimed to investigate the influence of postoperative tibial sesamoid position (TSP) on functional outcome and patient satisfaction after hallux valgus surgery.
  
  
  METHODS
  Between February 2007 and November 2011, 250 patients who underwent hallux valgus surgery at our tertiary hospital were followed for 2 years after surgery. They were categorized into 2 groups based on Hardy and Clapham's TSP classification, recorded on postoperative weight-bearing anteroposterior (AP) radiographs: (1) normal (grades I-IV) and (2) outliers (grades V-VII).
  
  
  RESULTS
  The mode TSP improved from grade VII preoperatively to grade IV postoperatively (P < .001). The visual analog scale for pain was 1 (95% CI 0, 1) point better in the normal group compared to the outlier group at 2 years after surgery (P = .050), whereas the American Orthopaedic Foot & Ankle Society Hallux Metatarsophalangeal-Interphalangeal Scale was 6 (95% CI 2, 11) points higher in the normal group (P = .009). Patients in the outlier group were also more likely to be dissatisfied with the surgery performed when compared to the normal group (OR 3.881, 95% CI 1.689, 8.920, P = .001).
  
  
  CONCLUSIONS
  We recommend correcting the TSP to grade of IV or less to improve functional outcome and satisfaction after hallux valgus surgery.
  
  
  METHODS
  Level III, retrospective comparative series.
authors: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore yqjchen@gmail.com.
authors: Jerry Yongqiang
authors: JY
authors: Chen
authors: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
authors: Kiran
authors: K
authors: Rikhraj
authors: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
authors: Cheryl
authors: C
authors: Gatot
authors: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
authors: Justine Yun Yu
authors: JY
authors: Lee
authors: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
authors: Inderjeet
authors: I
authors: Singh Rikhraj
mesh_terms: D006215:Hallux Valgus / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D010549:Personal Satisfaction; D011859:Radiography / Q000379:methods; D012189:Retrospective Studies; D012716:Sesamoid Bones / Q000503:physiopathology / Q000601:surgery*; D013977:Tibia; D016474:Weight-Bearing
keywords: Hallux valgus; functional outcome; satisfaction; tibial sesamoid position