A comparison of two designs of post-operative shoe on function, satisfaction and back pain after hallux valgus surgery

S. Patel, P. Garg, M.A. Fazal, M.S. Shahid, D. Park, P.S. Ray

Introduction: The scarf osteotomy affords stable fixation and immediate bearing of weight after hallux valgus surgery. Our unit has historically used a reverse camber shoe (RCS) for forefoot offloading but this is associated with back pain. Newer types of shoe are available; one of which is the DJO Podalux shoe which has a more uniform profile with a lower heel height and forefoot rocker, and a removable insert to convert the sole rigid to flexible allowing hallux movements. The purpose of this prospective audit was to identify if the introducing this newer design affected patient outcomes.

Methods: Data was prospectively collected on 80 feet in 78 eligible patients. The first 40 feet were given a RCS and once the Podalux shoe was made available, the next 40 feet were given this. Assessment tools included: the MOXFQ, a five question survey on the footwear, presence of back pain, complications experienced, compliance and radiographs for loss of correction.

Results: MOXFQ and shoe satisfaction significantly improved in both groups from two to six weeks with no significant difference between groups using using these tools at each time point. However, back pain was seen in six patients using the RCS of which five stopped using it as a direct consequence. Conversely, no patients with the Podalux shoe experienced back pain. No loss of correction was seen in any patient.

Conclusion: Both the RCS and Podalux shoe equal foot specific functional and radiological outcomes, but the latter shoe type is associated with less back pain and better compliance.