Do Weight-bearing Films Affect Decision Making in Hallux Valgus Surgery?

NewsBot · Dec 26, 2011

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Do Weight-bearing Films Affect Decision Making in Hallux Valgus Surgery?
Alon Burg, et al
Journal of Foot and Ankle Surgery; Article in Press

Hallux valgus is a complex deformity of the first ray and forefoot that can be surgically treated using different procedures and osteotomies. Preoperative planning includes anteroposterior and lateral plain films. The effect of weight-bearing on the results of the standardized measurements is still the subject of debate. We evaluated the effect of weight-bearing on the results of measurements and decision making by expert evaluators. A total of 21 foot and ankle surgeons were given weight-bearing and non–weight-bearing anteroposterior plain foot films of patients with hallux valgus. They were asked to measure 3 standard angles and then to select the most appropriate procedure from a short list. Using a paired Student's t test, no difference in the angles measured nor in the procedures chosen was detected between the weight-bearing and non–weight-bearing films. Although it is generally accepted that decisions regarding the treatment of hallux valgus should be based on plain weight-bearing films, in the present study, we established that non–weight-bearing films can reliably be used to choose the surgical procedure.
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docbourke · Dec 30, 2011

I have suspected thus for a long time, we have previously shown that there is a large intra-observer and inter observer error in reading all x rays. I also suspect that the angle of the films taken by the radiographer is going to affect the hallux valgus angles more than the weight bearing. The angle of the beam may significantly change with weight bearing and this will be interpreted as a change due to weight bearing not due to the change of x ray angle.
Gerard Bourke

mchad500 · Dec 30, 2012

In light of this study I'm uncertain as to why ABPS along with other boards dictate in their certification guidelines that pre-op weight bearing films are needed for hallux vagus surgery?

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docbourke Active Member

mchad500 Member

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