Background: Functional and health-related quality-of-life data on a
population of patients with hallux valgus are lacking. Similarly, the
correlation of the severity of the deformity with these measures is
Methods: Two hundred and eighty-five women with an average age of
forty-nine years who were scheduled for bunion surgery were enrolled in the
study. The patients completed a baseline American Academy of Orthopaedic
Surgeons (AAOS) foot and ankle outcomes questionnaire, which includes the
Short Form-36 (SF-36) and a specific lower-extremity section on the foot and
ankle. Preoperative radiographic data with regard to the hallux valgus angle
and the intermetatarsal angle were stratified into groups according to the
severity of the deformity (mild, moderate, or severe). The data were then
stratified into age-groups consistent with those reported for the SF-36, and
the results were compared with the SF-36 scores for the general population.
The global foot and ankle score and the shoe comfort score were compared with
general population scores that were published previously. The severity of the
preoperative deformity was correlated with the baseline scores.
Results: General health scores were noted to be relatively stable
throughout the age-groups for patients with bunions, with the older groups
demonstrating better scores than the general population. Bodily pain scores
were consistently worse for patients with a bunion through all age-groups
compared with the general population. The average global foot and ankle score
and the shoe comfort score were significantly lower (p < 0.001 for both)
for the patients with a bunion than for the general population. The severity
of the preoperative deformity did not correlate with any of the outcome
Conclusions: The bodily pain score from the SF-36 appears to be a
sensitive measure of problems experienced by patients undergoing bunion
surgery. Surprisingly, the severity of the deformity as measured
radiographically did not correlate with any of the fifteen scores measured.
These data may serve as a baseline for clinical hallux valgus studies with use
of the SF-36 or the AAOS outcomes questionnaire.