Abstract
BackgroundVarious clinical and radiological criteria have been suggested to choose one of the numerous techniques in surgical treatment of hallux valgus and rigidus. We hypothesized that the surgeons' professional background will influence that choice depending on specialization, age, type and institution of training as well as his orthopaedic cultural orientation. Since Switzerland is characterized by regional languages (the most important being German and French), we were interested to learn if the linguistic differences had an influence on the orientation of the surgeons towards e.g. Anglo-American or French surgical traditions and/or sources of literature on the subject.MethodsA survey was e-mailed to all members of the Swiss Orthopaedic Society (SGOT-SSOT). Questions were asked regarding respondents’ demographics as well as their preferred treatment for 3 separate cases of (1) moderate and (2) severe hallux valgus and (3) hallux rigidus. The responses were collected and statistically analyzed.ResultsTwo hundred thirty of 322 respondents completed the survey(response rate 46 %). as they perform foot surgery on a regular base; 39 % were members of the Swiss Orthopaedic Foot and Ankle Society (SFAS). Selected surgical treatments differed as follows: in joint sparing procedures older and busier surgeons were more likely to use Chevron osteotomies, however more than 50 % preferred a Scarf-type of osteotomy. Along the so-called "Rösti-Graben" separating the French from the German speaking part of Switzerland no significant difference was found in the choice of operation technique.Nevertheless the fact being a member of SFAS showed significant differences in technical choice in case 2 and 3.ConclusionsThere are significant associations between the surgeons’ age, expertise and training and their preferred operative intervention. Considerable differences in the surgical management were found in the practice of the general orthopaedic surgeons 72 and the foot and ankle specialists. The cultural background and training is not mirroring the classical Swiss east west discrepancy. Despite the large number of surgical options available for hallux valgus, only a small number were preferred by the majority of surgeons.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-015-0751-7) contains supplementary material, which is available to authorized users.
Highlights
Various clinical and radiological criteria have been suggested to choose one of the numerous techniques in surgical treatment of hallux valgus and rigidus
Hallux valgus and hallux rigidus are common conditions for which numerous operative interventions have been described in the literature [1,2,3,4]
We presented the questions of the Australian survey to Swiss orthopaedic surgeons aiming to identify factors that influenced their choice of treatment with special emphasis on that demographic peculiarity [21]
Summary
Various clinical and radiological criteria have been suggested to choose one of the numerous techniques in surgical treatment of hallux valgus and rigidus. We hypothesized that the surgeons' professional background will influence that choice depending on specialization, age, type and institution of training as well as his orthopaedic cultural orientation. The surgeons’ professional background may influence that choice, depending on surgeons’ specialization, age, type and institution of training as well as their orthopaedic cultural orientation [8,9,10,11,12,13,14,15,16,17,18,19,20]. Younger surgeons with a selective foot and ankle training tend to do more Scarf osteotomies in mild to moderate cases and metatarsaophalangeal (MTP)-I fusions in severe Hallux valgus or rigidus. A trend to less joint replacements is visible [21]
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