Why I Want Bunion Surgery-the Patient's Preoperative and Postoperative Perspective

Hallux valgus is the most common pathology afflicting the hallux. Surgery is generally offered to symptomatic patients who fail conservative treatment. The aim of this study is to evaluate patient-reported reasons for undergoing hallux valgus corrective surgery in a preoperative and postoperative cohort.

We performed a prospective and retrospective cross-sectional study. Our study included all patients aged >18 years who were planning to or have had hallux valgus surgery during the study period. An information sheet including 14 possible reasons for having hallux valgus surgery and a questionnaire to rank each reason (1-10) was sent to all patients. Patients were divided into a preoperative group and a postoperative group to eliminate bias. In our study we had 101 patients, 5 males and 96 females, at an average age of 50.6 years.

The preoperative cohort included 51 patients and the postoperative cohort 50 patients. The 3 most important reasons for having surgery, in both cohorts, were the ability to move pain free, eliminate pain over bunion, and to be able to walk long distance and over uneven terrain without pain. The 3 least important factors were to reduce the need for an orthotic, narrower foot, and to wear high heels. Indications were divided into one of 4 categories. Pain was the highest-rated category in both pre and postoperative groups, followed by function. In the preoperative group, appearance was the next most important group and shoe wear the least. In comparison, in the postoperative group, shoe wear was more important than appearance.

Pain and function are the most important reasons patients have for surgery in both the preoperative and postoperative patient cohorts. Patients were more likely to list cosmesis as a reason to undergo surgery in the preoperative than the postoperative group.