Scoring in forefoot surgery: a statistical evaluation of single variables and rating systems

We assessed 13 scores for forefoot surgery and their single parameters in 200 cases of hallux surgery. Outcome expressed in descriptive terms from excellent to poor, as well as calculated as a numerical value differed to a great extent. The rank correlation between different scores showed poor conformity, in some combinations even slight negative correlations. The rank correlation between single parameters and the overall outcome gave good values for some variables included in most scores, e.g., walking distance, general activity, problems on uneven surfaces, shoe wear, cosmetics and pain. Little, if any, correlation was found for joint instability, range of motion of the MTP- and IP-joints, the use of walking aids and medication. We find a need for a generally accepted score, with parameters of high clinical relevance.