Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Foot Ankle Surg. 2021 Jul;27(5):539-542. doi: 10.1016/j.fas.2020.07.001. Epub 2020 Jul 8.
Hallux valgus is a common forefoot deformity that affects function of foot and quality of life (QoL). This study aims to identify factors associated with clinically important improvements in QoL after hallux valgus corrective surgery.
A retrospective analysis on 591 cases of hallux valgus corrective surgery performed between 2007 and 2013 was conducted. Patients' preoperative and 2-year postoperative Physical Component Score (PCS) and Mental Component Score (MCS) were compared to identify the presence of clinically significant improvements in patient-reported QoL. A multiple logistic regression model was developed through a stepwise variable-selection model building approach. Age, BMI, preoperative patient reported outcome score, PCS, MCS, pain score, gender, side of surgery, type of surgery, and presence of lesser toe deformities or metatarsalgia were considered.
Median PCS significantly improved from 49 to 53 (p < 0.001), and median MCS remained at 56 (p = 0.724). Age, preoperative MCS and PCS were independent predictors for significant improvements of PCS at 2-year postoperatively.
Three groups of patients were more likely to have significant QoL improvements after hallux valgus corrective surgery. These were the younger patients, those with better preoperative mental health or those with poorer preoperative physical health.
III.
拇外翻是一种常见的前足畸形，会影响足部功能和生活质量（QoL）。本研究旨在确定与拇外翻矫正手术后 QoL 临床显著改善相关的因素。
对 2007 年至 2013 年间进行的 591 例拇外翻矫正手术进行回顾性分析。比较患者术前和术后 2 年的物理成分评分（PCS）和心理成分评分（MCS），以确定患者报告的 QoL 是否存在临床显著改善。通过逐步变量选择模型构建方法开发了多变量逻辑回归模型。考虑了年龄、BMI、术前患者报告的结果评分、PCS、MCS、疼痛评分、性别、手术侧、手术类型以及小趾畸形或跖痛的存在。
中位 PCS 从 49 显著改善至 53（p < 0.001），而中位 MCS 保持在 56（p = 0.724）。年龄、术前 MCS 和 PCS 是术后 2 年 PCS 显著改善的独立预测因素。
三组患者在接受拇外翻矫正手术后更有可能获得 QoL 的显著改善。这些患者是年轻患者、术前心理健康状况较好的患者或术前身体状况较差的患者。
III 级。
