Preoperative photography improves patient satisfaction following hallux valgus surgery

Comparison of different osteotomy schemes in the repair and treatment of moderate to severe hallux valgus deformities

To explore the application efficacy and safety of different osteotomy schemes in the repair and treatment of moderate to severe hallux valgus deformities. A sum of 117 patients with moderate to severe acute hallux valgus who underwent treatment at our hospital from April 2020 to April 2022 were selected. The envelope method was used to group the patients. The control group (n = 58) underwent double-plane osteotomy of the first metatarsal bone, while the observation group (n = 59) underwent Scarf osteotomy. The clinical efficacy of the 2 groups was compared, the differences in imaging results between the 2 groups at 6 months after surgery were analyzed, and the occurrence of complications during the follow-up period was observed. The excellent rate of the study group patients was 83.05% (49/59), which was compared to that of the control group (81.03%, 47/58) (P > .05). In comparison to the control group patients, the pain, force line, and joint function scores of the study group were compared before surgery and at 3 months after surgery (P > .05). Compared to before surgery, the pain, force line, joint function scores, The American Orthopaedic Foot & Ankle Society (AOFAS) total score, and Berg Balance Scale (BBS) score of the patients in both groups increased at 3 months after surgery. Additionally, the AOFAS total score and BBS score of the study group patients were higher than those of the control group patients (P < .05). The visual analog scale (VAS) scores of the patients in the 2 groups were compared before surgery (P > .05). The VAS scores of the study group patients were higher than those of the control group patients at 1, 2, and 3 months after surgery (P < .05). The study group patients were compared with the control group patients in terms of the hallux valgus angle, the lengths of the first and second metatarsals, the angle between the first and second metatarsals, the angle of the metatarsophalangeal joint surface, the position of the sesamoids, and the shortening length of the first metatarsal (P > .05). The Scarf osteotomy has shown advantages in postoperative gait balance and functional scoring. Therefore, when choosing an osteotomy plan, the Scarf osteotomy can be given priority to enhance the patient's balance ability and enhance their postoperative quality of life.

Estimation of the Radiographic Parameters for Hallux Valgus From Photography of the Feet Using a Deep Convolutional Neural Network

BACKGROUND

Hallux valgus (HV), also known as bunion deformity, is one of the most common forefoot deformities. Early diagnosis and proper evaluation of HV are important because timely management can improve symptoms and quality of life. Here, we propose a deep learning estimation for the radiographic measurement of HV based on a regression network where the input to the algorithm is digital photographs of the forefoot, and the radiographic measurement of HV is computed as output directly. The purpose of our study was to estimate the radiographic parameters of HV using deep learning, to classify the severity by grade, and to assess the agreement of the predicted measurement with the actual radiographic measurement.

METHODS

There were 131 patients enrolled in this study. A total of 248 radiographs and 337 photographs of the feet were acquired. Radiographic parameters, including the HV angle (HVA), M1-M2 angle, and M1-M5 angle, were measured. We constructed a convolutional neural network using Xception and made the classification model into the regression model. Then, we fine-tuned the model using images of the feet and the radiographic parameters. The coefficient of determination (R2) and root mean squared error (RMSE), as well as Cohen's kappa coefficient, were calculated to evaluate the performance of the model.

RESULTS

The radiographic parameters, including the HVA, M1-M2 angle, and M1-M5 angle, were predicted with a coefficient of determination (R2)=0.684, root mean squared error (RMSE)=7.91; R2=0.573, RMSE=3.29; R2=0.381, RMSE=5.80, respectively.

CONCLUSION

The present study demonstrated that our model could predict the radiographic parameters of HV from photography. Moreover, the agreement between the expected and actual grade of HV was substantial. This study shows a potential application of a convolutional neural network for the screening of HV.

[Translated article] The effect of showing preoperative photographs on patient satisfaction following forefoot surgery

BACKGROUND

Postoperative outcome measurement typically relies on postoperative radiological results and clinical-functional scales; however, there is a growing interest in considering patient satisfaction (including subjective aspects) as part of the success of forefoot surgery.

OBJECTIVE

To determine whether showing a preoperative photograph improves satisfaction in postoperative forefoot surgery patients.

MATERIAL AND METHODS

An observational, cross-sectional, analytical study was conducted in the foot and ankle unit of our centre. We included 120 participants between 18 and 90 years old who underwent forefoot surgery. The degree of satisfaction was compared using the PSQ-10 questionnaire between a group of patients who received a preoperative foot appearance image at their 3-month postoperative follow-up and those who did not receive it.

RESULTS

The overall satisfaction rate was 78.33% at 3 months after the intervention. The 93.6% of patients who received the photograph were satisfied at the postoperative follow-up, while in the control group, it was 86.2% with a p value of 0.218.

CONCLUSION

The degree of satisfaction in patients undergoing forefoot surgery is not associated with the presentation of preoperative photographs.

The effect of showing preoperative photographs on patient satisfaction following forefoot surgery

BACKGROUND

Postoperative outcome measurement typically relies on postoperative radiological results and clinical-functional scales; however, there is a growing interest in considering patient satisfaction (including subjective aspects) as part of the success of forefoot surgery.

OBJECTIVE

To determine whether showing a preoperative photograph improves satisfaction in postoperative forefoot surgery patients.

MATERIAL AND METHODS

An observational, cross-sectional, analytical study was conducted in the foot and ankle unit of our center. We included 120 participants between 18 and 90 years old who underwent forefoot surgery. The degree of satisfaction was compared using the PSQ-10 questionnaire between a group of patients who received a preoperative foot appearance image at their 3-month postoperative follow-up and those who did not receive it.

RESULTS

The overall satisfaction rate was 78.33% at 3 months after the intervention. The 93.6% of patients who received the photograph were satisfied at the postoperative follow-up, while in the control group, it was 86.2% with a p-value of 0.218.

CONCLUSION

The degree of satisfaction in patients undergoing forefoot surgery is not associated with the presentation of preoperative photographs.