Togay Koç / 26 June 2022 / Categories: Abstracts, 2013, Podium Does bunion surgery actually narrow the foot? Assessment of outcomes of surgery using traditional angles and a new radiographic measure of severity - the forefoot: hindfoot ratio. A.M. Perera, L. Beddard, A. Marudunayagam Background: Various angles have been used to grade the severity of hallux valgus deformity. They are useful in surgical planning but do not correlate with symptom severity or improvement. We feel that there is a fundamental mismatch between the width of the forefoot and the width of the hindfoot and that this is more clinically relevant, we describe two techniques for measuring this. We aim to measure the degree of foot narrowing after surgery and moreover how this correlates to the severity of pre- and post operative outcomes. Methods: 200 consecutive bunion operations were assessed with weight bearing radiographs. The HVA and IMA were measured according to standard practice. We also assessed forefoot width using two methods we have described. The first is the ‘Forefoot Width’ measured as a perpendicular to the midfoot (a technique we have previously validated). The ‘Foot Ratio’ is calculated as a function of the calcaneal width. Clinical outcomes were assessed using the MOXFQ and AOFAS. Results: Bunion surgery narrows the osseous width of the forefoot. This narrowing can be by as much as 23mm in cases with severe deformity. We found that the Forefoot: Hindfoot ratio correlated with symptom severity and that normalisation of the ratio to below 2.5 was associated with better outcomes. This is important as small absolute corrections were associated with good outcomes. Conclusion: Our measure of Forefoot Width is reproducible and allows for variations such as forefoot adductus. We feel that the Forefoot:Hindfoot ratio is more important as this determines the ability to fit into off-the-shelf footwear rather than requiring bespoke or modified footwear. This is the first study to look at the ability to narrow the forefoot and has important implications in determining patient selection and post-operative outcomes. Print 421 Tags: Hallux Valgus
28Apr2025 BOFAS Diabetic Foot Principles Course - Milton Keynes 2025 28/04/2025 Read more BOFAS Diabetic Foot Principles Course - Milton Keynes 2025 The BOFAS Diabetic Foot Principles Course is an exciting new course designed for Orthopaedic trainees and consultants. Click here to register. Documents to download BOFAS-Course-Programme-2025(.docx, 169.12 KB) - 467 download(s) Read more
3Jul2025 Basic Skills Foot and Ankle Arthroscopy Course - open for applications 03/07/2025 Read more This courses is designed to develop and extend the knowledge and skills of training foot and ankle surgeons. Techniques of arthroscopic surgery of the joints, ligaments and tendons of the ankle and foot will be presented and demonstrated. Basic Skills covers the more common procedures which a foot and ankle surgeon would be likely to need. Delegates will be given ample time to develop their skills in each of the areas listed below using cadaver limbs. Questions and case presentations will be encouraged with an expert and interactive faculty. Anterior ankle Posterior ankle Haglund’s surgery Sub-talar joint Tendoscopy Arthroscopic Ankle fusion 1st MTP joint Documents to download Basic-Course-2025-Programme-draft(.pdf, 3.19 MB) - 281 download(s) Read more
4Jul2025 Advanced Skills Foot and Ankle Arthroscopy Course - applications open 04/07/2025 Read more This courses is designed to develop and extend the knowledge and skills of established foot and ankle surgeons. Techniques of arthroscopic surgery of the joints, ligaments and tendons of the ankle and foot will be presented and demonstrated. Advanced Skills covers some more advanced and emerging techniques. Delegates will be given ample time to develop their skills in each of the areas listed below using cadaver limbs. Questions and case presentations will be encouraged with an expert and interactive faculty. 1st MTP joint Arthroscopic lateral and medial ligament repair FHL transfer Peroneal groove and Tibialis posterior Tarsal coalition excision Sub-talar fusion Chopart joint fusion Documents to download Advanced-Course-2025-Programme-draft(.pdf, 3.29 MB) - 282 download(s) Read more
20Oct2025 BOFAS Principles Course Taunton 20/10/2025 - 21/10/2025 Read more These courses are aimed at Higher Surgical Trainees / ST3 onwards and are designed to teach the core of Foot and Ankle surgery in an informal and interactive environment. The emphasis is on clinical examination cases, discussion groups and typical day-to-day clinic scenarios. Although not an exam preparation course, content is taught to the standard expected in the FRCS(Tr & Orth) exam; that of a day-one non-specialist orthopaedic consultant. Applications will open on 1st September 2023. Venue - Taunton (TBC) Documents to download BOFAS-Course-Programme--Taunton-2025(.docx, 31.88 KB) - 495 download(s) Read more
15May2025 Oswestry Cartilage Meeting 15/05/2025 - 16/05/2025 Read more Oswestry Cartilage Meeting 15-16th May, 2025 Keele Hall, Keele University Registration fee £250 (PhD Students £125) - closing: 31st March Further information & Registration Documents to download 2025_Keele_Cartilage_Symposium_Flyer_2025__1_(.pdf, 434.4 KB) - 87 download(s) Read more
5Jun2025 2nd Annual London Orthopaedic Meeting 05/06/2025 - 06/06/2025 Read more 2nd Annual London Orthopaedic Meeting 5th-6th June 2025 The Chicago Booth London Conference Centre, London, UK Read more
7Jun2025 World Orthopaedic Concern UK 07/06/2025 Read more World Orthopaedic Concern UK WOC is a charitable organisation and is a specialist society of the British Orthopaedic Association promoting orthopaedic education and care in developing countries. If you are interested in global orthopaedic initiatives, then click for more information. Documents to download 2025_WOC_conference_poster_FINAL(.pdf, 1.14 MB) - 90 download(s) Read more
7Jun2025 World Orthopaedic Concern UK 07/06/2025 Read more World Orthopaedic Concern UK WOC is a charitable organisation and is a specialist society of the British Orthopaedic Association promoting orthopaedic education and care in developing countries. If you are interested in global orthopaedic initiatives, then click for more information. Read more