Hallux valgus: immediate operation versus 1 year of waiting with or without orthoses: a randomized controlled trial of 209 patients

Abstract

Hallux valgus operations can not always be done immediately because of long waiting lists. In this study, 209 consecutive patients (mean age 48 years, 93% female) with a painful hallux valgus were randomized into 3 groups: immediate operation or 1 year waiting with or without foot orthoses. The follow-up period was 2 years. The main outcome measurement was the intensity of pain during walking. During the first year, 64/71, 0/69 and 4/69 patients were operated on in the surgery, orthosis and no orthosis groups, respectively, and during the 2-year follow-up, 66, 43 and 48, respectively. At the 1-year follow-up, the pain was least intense in the surgery group. At the 2-year follow-up, the intensity of pain was similar in all groups. The satisfaction with treatment was best in the surgery and orthosis groups. The total costs of care were similar in all groups. We conclude that immediate operation is superior to delayed operation or foot orthoses. However, if this is not possible because of limited possibilities for surgery, waiting for 1 year, with or without an orthosis, does not jeopardize the final outcome.