Using Manchester Scale classification of Hallux Valgus as a valuable tool in determining appropriate risk categorization during initial diabetic foot screening in primary health care settings

Effects of custom insoles for symptomatic hallux valgus: protocol for a sham-controlled randomised trial

INTRODUCTION

Hallux valgus (HV) is one of the most prevalent forefoot deformities, and its frequency increases with age, reaching nearly 23% in adulthood (females are usually more affected). Studies on customised insoles and orthoses for HV showed inconclusive results. There is no consensus in literature regarding the ideal insole or length of use for pain relief or functional improvement in individuals with HV. This study will assess the effects of a customised insole with retrocapital bar associated with an infracapital bar of the first metatarsal on pain and function of individuals with symptomatic HV.

METHODS

This is the protocol for a blinded, sham-controlled randomised clinical trial. Eighty participants with symptomatic HV will be randomised into two groups (40 per group): customised insole or sham insole. Assessments will be performed at baseline (T0), six (T6) and 12 weeks (T12) of intervention. A follow-up will occur after 4 weeks of intervention (T16). The primary and secondary outcomes will be pain (Numerical Pain Scale) and function (Foot Function Index), respectively.

STATISTICAL ANALYSIS

Analysis of variance with a mixed design or Friedman's test will be considered according to data distribution; post-hoc analyses will be performed using Bonferroni test. Time × group interaction and within-group and between-group differences will also be assessed. The intent-to-treat analysis will be used. A significance level of 5% and 95% s will be adopted for all statistical analyses.

ETHICS AND DISSEMINATION

This protocol was approved by the research ethics committee of the Faculty of Health Sciences of Trairi/Federal University of Rio Grande do Norte (UFRN/FACISA; opinion number 5411306). The study results will be disseminated to participants, submitted to a peer-reviewed journal and presented in scientific meetings.

TRIAL REGISTRATIONS NUMBER

NCT05408156.

Development of a preoperative questionnaire to improve satisfaction with hallux valgus repair: A Delphi study

BACKGROUND

Satisfaction with hallux valgus repair is often poor, despite good surgical outcomes. Many tools have been developed to assess the outcome of the procedure; however none evaluate the association between the initial motive for repair and the reasons for post-surgical dissatisfaction. The aim of this study was to develop a new tool to analyse the subjective and objective expectations of individuals during a pre-operative consultation for hallux valgus repair in order to improve post-surgical satisfaction.

METHODS

We first collected the reasons for dissatisfaction with repair from the medical files of dissatisfied individuals. Then, a steering committee of 4 French experts in the management of hallux valgus designed a questionnaire based on the reasons for dissatisfaction. We then used the DELPHI method to validate the questionnaire: we submitted the questionnaire to a panel of 34 francophone experts in hallux valgus repair for rating in 4 rounds.

RESULTS

The medical files of 853 individuals were reviewed and a 52-item questionnaire relating to expectations from hallux valgus surgery was drafted. After the 4 rounds, a final 44 item questionnaire reached consensus. Thirteen items related to clinical and psychological profile, 5 to pain, 9 to physical activity, 4 to aesthetics and 13 to footwear.

CONCLUSION

This tool should facilitate gathering of individuals' expectations from hallux valgus repair to ensure realistic goals and reduce post-surgical dissatisfaction.