DETERMINATION OF THE RISK OF OBTAINING UNSATISFACTORY RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH STATIC DEFORMITIES OF THE FOREFOOT WHEN USING VARIOUS SURGICAL APPROACHES

Abstract

The main method of treatment of static deformations of the forefoot (SDPVS) is surgical. The most static deformities of the foot in its front part most often include valgus deformity of the first toe — Hallux valgus (HV), hammer-like deformities of 2–4 toes, and Taylor's deformity. Objective. To assess the effectiveness of surgical treatment of SDPVS and to determine the risk of obtaining an unsatisfactory result with different surgical approaches. Methods. The treatment of 565 patients (1009 feet) was analyzed, the main group — 729 feet, control 280 feet. The groups of patients differed in the methods of surgical treatment of deformities of the forefoot. The choice of surgical intervention in the main group was carried out according to the algorithmized system of surgical treatment of patients with SDPVS. Results. The results of treatment of patients with static deformities of the front part of the foot in the main group were significantly (p < 0.001) better than the results in the control group of patients. In the main group, good results accounted for 55.0 % of cases, satisfied — 39.2 %, unsatisfactory — 5.8 %, compared to the control group — 26.1 %, 43.2 and 30.7 %, respectively. The reduction of the relative risk of obtaining an unsatisfied result (RRR) in the main group when using the proposed algorithmized system of treatment of SDPVS is 68 %. In the treatment of combined VDPPS with deformities of 2–5 toes, the risk of an unsatisfactory result is higher compared to isolated VDPPS in both groups. The risk of an unsatisfactory treatment result in patients with combined HV deformity and deformities of 2–5 toes in the control group is 15.9 % higher (RR = 0.159 ± 0.174) than in the main group. The use of the proposed approach to the selection of surgical treatment tactics based on the developed algorithmized system of surgical treatment of SDPVS can reduce the relative risk of obtaining unsatisfactory treatment results by 84 % (RRR = 0.841).