[Hallux valgus: the McBride procedure or subcapital osteotomy?]

Area of Science:

• Orthopedic Surgery
• Podiatric Medicine
• Biomechanical Analysis

Background:

• Hallux valgus (bunion) is a common foot deformity.
• Surgical interventions aim to correct deformity, alleviate pain, and improve function.
• Long-term outcomes of different surgical techniques require thorough evaluation.

Purpose of the Study:

• To compare the long-term clinical and radiological outcomes of the McBride and Hohmann procedures for hallux valgus.
• To assess patient satisfaction, pain levels, mobility, and deformity reduction.
• To determine optimal indications for each surgical technique based on patient presentation.

Main Methods:

• A long-term follow-up study (mean 19 years) of 96 hallux valgus patients.
• Comparison of 52 patients treated with the McBride procedure and 46 with the Hohmann procedure (osteotomy).
• Clinical evaluation included deformity, pain, mobility, and satisfaction; radiological assessment used weight-bearing X-rays.

Main Results:

• Patients reported significantly higher subjective satisfaction with the McBride procedure (p=0.0001).
• Radiological assessment showed a statistically better reduction of deformity with osteotomy (p=0.006).
• The modified McBride procedure was more suitable for painful hallux valgus; osteotomy was better for less painful bunions.

Conclusions:

• Subjective patient satisfaction is a critical outcome measure, potentially outweighing radiological findings in hallux valgus surgery.
• The choice between McBride and osteotomy should prioritize patient history and clinical examination over purely radiographic results.
• Understanding the discrepancy between radiological and subjective outcomes is key to successful hallux valgus surgical management.