Togay Koç / 26 June 2022 / Categories: Abstracts, 2013, Podium Does bunion surgery actually narrow the foot? Assessment of outcomes of surgery using traditional angles and a new radiographic measure of severity - the forefoot: hindfoot ratio. A.M. Perera, L. Beddard, A. Marudunayagam Background: Various angles have been used to grade the severity of hallux valgus deformity. They are useful in surgical planning but do not correlate with symptom severity or improvement. We feel that there is a fundamental mismatch between the width of the forefoot and the width of the hindfoot and that this is more clinically relevant, we describe two techniques for measuring this. We aim to measure the degree of foot narrowing after surgery and moreover how this correlates to the severity of pre- and post operative outcomes. Methods: 200 consecutive bunion operations were assessed with weight bearing radiographs. The HVA and IMA were measured according to standard practice. We also assessed forefoot width using two methods we have described. The first is the ‘Forefoot Width’ measured as a perpendicular to the midfoot (a technique we have previously validated). The ‘Foot Ratio’ is calculated as a function of the calcaneal width. Clinical outcomes were assessed using the MOXFQ and AOFAS. Results: Bunion surgery narrows the osseous width of the forefoot. This narrowing can be by as much as 23mm in cases with severe deformity. We found that the Forefoot: Hindfoot ratio correlated with symptom severity and that normalisation of the ratio to below 2.5 was associated with better outcomes. This is important as small absolute corrections were associated with good outcomes. Conclusion: Our measure of Forefoot Width is reproducible and allows for variations such as forefoot adductus. We feel that the Forefoot:Hindfoot ratio is more important as this determines the ability to fit into off-the-shelf footwear rather than requiring bespoke or modified footwear. This is the first study to look at the ability to narrow the forefoot and has important implications in determining patient selection and post-operative outcomes. Print 464 Tags: Hallux Valgus
3Jul2025 Basic Skills Foot and Ankle Arthroscopy Course - open for applications 03/07/2025 Read more This courses is designed to develop and extend the knowledge and skills of training foot and ankle surgeons. Techniques of arthroscopic surgery of the joints, ligaments and tendons of the ankle and foot will be presented and demonstrated. Basic Skills covers the more common procedures which a foot and ankle surgeon would be likely to need. Delegates will be given ample time to develop their skills in each of the areas listed below using cadaver limbs. Questions and case presentations will be encouraged with an expert and interactive faculty. Anterior ankle Posterior ankle Haglund’s surgery Sub-talar joint Tendoscopy Arthroscopic Ankle fusion 1st MTP joint Documents to download Basic-Course-2025-Programme-draft(.pdf, 3.19 MB) - 418 download(s) Read more
4Jul2025 Advanced Skills Foot and Ankle Arthroscopy Course - applications open 04/07/2025 Read more This courses is designed to develop and extend the knowledge and skills of established foot and ankle surgeons. Techniques of arthroscopic surgery of the joints, ligaments and tendons of the ankle and foot will be presented and demonstrated. Advanced Skills covers some more advanced and emerging techniques. Delegates will be given ample time to develop their skills in each of the areas listed below using cadaver limbs. Questions and case presentations will be encouraged with an expert and interactive faculty. 1st MTP joint Arthroscopic lateral and medial ligament repair FHL transfer Peroneal groove and Tibialis posterior Tarsal coalition excision Sub-talar fusion Chopart joint fusion Documents to download Advanced-Course-2025-Programme-draft(.pdf, 3.29 MB) - 413 download(s) Read more
2Oct2025 BOFAS Principles Course - Dubai 02/10/2025 - 04/10/2025 Read more The aim is to give Overseas Trainee Orthopaedic Surgeons a solid grounding in the principles and the decision making in Foot & Ankle Surgery. There is an emphasis on clinical examination of cases, small group discussions and learning surgical approaches in the cadaver lab. This is the first course BOFAS is running in UAE and the aim is to expand the Foot and Ankle education and training in the Middle East and Gulf area. Venue - Le Meridien, Dubai, United Arab Emirates Documents to download ACv3BOFAS-Principles-Course-Programme-DXB(.pdf, 2.13 MB) - 115 download(s) Read more
20Oct2025 BOFAS Principles Course Taunton 20/10/2025 - 21/10/2025 Read more These courses are aimed at Higher Surgical Trainees / ST3 onwards and are designed to teach the core of Foot and Ankle surgery in an informal and interactive environment. The emphasis is on clinical examination cases, discussion groups and typical day-to-day clinic scenarios. Although not an exam preparation course, content is taught to the standard expected in the FRCS(Tr & Orth) exam; that of a day-one non-specialist orthopaedic consultant. Applications will open on 1st September 2023. Venue - Taunton (TBC) Documents to download BOFAS-Course-Programme--Taunton-2025(.docx, 31.88 KB) - 575 download(s) Read more
7Nov2025 TriCountries Diabetic Foot Symposium 07/11/2025 Read more TriCountries Diabetic Foot Symposium In-person multidisciplinary event bringing together leading experts in the UK to discuss the latest advancements in diabetic foot care. Read more