Mohammed Elnaggar Jason Eyre Simon Sturdee Scarf osteotomy for Hallux Valgus correction – an audit of patient satisfaction Mohammed Elnaggar Jason Eyre Simon Sturdee

Why satisfaction audit? Ever more common procedure for Hallux Valgus correction (particularly amongst F&A community) Patients frequently ask success rates in clinic before committing to surgery To examine the role of Akin osteotomy To audit outcomes of Senior surgeons practice

Method Junior author identified all patients undergoing Scarf osteotomy in NHS (CRH) April 2008-Mar 2010 Patients contacted via telephone numbers registered in PAS system Asked a simple questionnaire of 4 questions (see next slide) Results recorded using Microsoft Excel

Sample Questionnaire Q1. degree of satisfaction Q2.if the other foot How satisfied are you with the surgery you have had for your bunion? (Very satisfied- satisfied-neutral- unsatisfied – very unsatisfied) Q2.if the other foot If you had the same problem with a painful bunion on the other foot would you have the same surgery on that foot ? Q3.if a friend or a relative Would you recommend the surgery to a friend who had a similar problem with a bunion? Q4.complications Have you had any complication from this surgery?

Patient demographics April 2008-Mar 2010 Total patients identified = 64 83 scarfs in 64 patients ( 19 bilateral) Total patients contactable = 42 53 scarfs in 42 patients (11 bilateral) Age range 17 – 89years ( mean age = 52 ) F: M = 54:10 = 5.4 : 1 Number of Akin + Scarf = 30 (36%)

Results

Q1 degree of satisfaction

Q2: repeating surgery

Q 3: recommending the surgery

Results: Q4 Complications Infection 3 (superficial) All resolved at 2 weeks with oral antibiotics No Chronic regional pain syndrome

Discussion >83% patients are satisfied with surgery at CRH in this single surgeon series Only 2 patients were unsatisfied(4.7%) 88 % would recommend this procedure to a friend or undergo it again >95% were either very satisfied, satisfied or neutral

Reproducible operation Powerful 3D correction in right hands Minimal complications consistent with other forms of corrective osteotomy

Summary Scarf procedure is successful , safe and reproducible correction of Hallux Valgus >83% of CRH / HRI patients satisfied with this surgery in this single surgeon series It can take 9-12 months for patients to fully recover from forefoot surgery, particularly swelling

Questions?

Thank you With thanks to PAS office, SWS secretary , audit department and enquiry desk for their help in collecting and presenting this data