Evaluation of follow-up results of McBride operative treatment for hallux valgus deformity.

BACKGROUND Hallux valgus still remains a problem in orthopaedic surgery, a fact attested to by over a hundred operating procedures for the correction of this deformity that have been elaborated until now. The aim of the study was to evaluate the results of the McBride procedure for surgical correction of the hallux valgus deformity using an anatomic & functional foot scoring system and roentgenometric assessment. MATERIAL AND METHODS 121 feet in 65 women who underwent the McBride procedure for a hallux valgus deformity at the Orthopaedic Department of the Wrocław University of Medicine in the years 1995-2001 were analysed. The follow-up period varied from 4 to 11 years, for an average of 6.5+4.2 years. Foot function was assessed with a scoring system developed by the author. The roentgenometric examination comprised the following parameters: hallux valgus angle, intermetatarsal angle 1-2, metatarsal I varus angle, and medial sesamoid displacement. RESULTS After the operation the number of painless feet as well as walking ability increased. The number of bunions and the number of painful callosities beneath metatarsal heads also decreased in a statistically significant manner. The average hallux valgus angle on physical examination decreased by 17.2 o. The mean overall functional score increased from 31.2 to 74.1 points, i.e. it rose by two categories, from 'poor' to 'good'. The overall satisfaction rate (excellent and good results) was 76.9%. There were 4 cases (3.3%) of hypercorrection and 14% of the 121 patients experienced a recurrence of the valgus deformity. CONCLUSIONS The McBride procedure is still useful in the treatment of hallux valgus for selected groups of patients, on condition that the qualification criteria are very strictly adhered to.