Contemporary surgical decision-making for hallux valgus and hallux rigidus in Switzerland: A national cross-sectional survey using standardized clinical scenarios.

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2026-04-10 DOI:10.1016/j.fas.2026.03.011

Gil Genuth, Jan Danek, Georg Klammer, Peter Stavrou, Lukas D Iselin

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引用次数: 0

Abstract

Background: Surgical management of hallux valgus and hallux rigidus is influenced by deformity severity, surgeon training, and evolving techniques. Previous surveys in Australia (2012), Switzerland (2015), and Israel (2023) using identical hypothetical cases demonstrated marked regional differences and a recent rise in minimally invasive Chevron-Akin (MICA). Whether these advances have altered contemporary Swiss practice remains unclear.

Methods: An electronic survey replicating the original questionnaire was distributed to members of the Swiss Foot and Ankle Society. Three standardized clinical cases were presented: mild hallux valgus, severe hallux valgus, and hallux valgus et rigidus. Respondents selected nonoperative versus operative management and specified procedures and fixation methods. Demographics, subspecialty training, and surgical volume were recorded. Current results were compared with prior Swiss data to assess temporal change.

Results: Eighty surgeons completed the survey (94% foot and ankle specialists). For mild hallux valgus, 87.7% recommended surgery; Scarf osteotomy remained most common (49.4%), followed by Chevron (21.0%) and Minimally Invasive Hallux Valgus correction (14.8%). Minimally Invasive adopters were predominantly mid-career (83% aged 41-50), high-volume surgeons. For severe hallux valgus, 95.1% favoured surgery; MTPJ arthrodesis was preferred (50.6% isolated; 11.1% with Lapidus), while Minimally Invasive Hallux Valgus correction was rarely chosen (2.5%). In hallux valgus et rigidus, 96% selected MTPJ fusion, most commonly plate-and-screw fixation (45.1%). Compared with 2015, fixation strategies evolved, yet procedure selection remained largely unchanged.

Conclusion: Despite global expansion of minimally invasive bunion surgery, Swiss surgeons continue to favour established open techniques, particularly Scarf osteotomy and fusion-based strategies. Adoption of MIS remains limited and concentrated among high-volume, mid-career specialists, indicating a cautious national diffusion pattern.

Level of evidence: IV, survey study.

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当代瑞士拇外翻和拇僵硬的手术决策：一项使用标准化临床方案的全国横断面调查。

背景：拇外翻和拇僵硬的手术治疗受到畸形严重程度、外科医生培训和不断发展的技术的影响。先前在澳大利亚（2012年）、瑞士（2015年）和以色列（2023年）进行的调查使用了相同的假设病例，结果显示出明显的地区差异，微创Chevron-Akin （MICA）的发病率最近有所上升。这些进步是否改变了当代瑞士的做法尚不清楚。方法：复制原始问卷的电子调查分发给瑞士足踝协会的成员。报告了轻度外翻、重度外翻和拇外翻合并僵直三种典型的临床病例。受访者选择非手术治疗和手术治疗，并指定手术和固定方法。记录人口统计学、亚专科培训和手术量。目前的结果与瑞士以前的数据进行比较，以评估时间变化。结果：80名外科医生完成了调查，其中94%是足部和踝关节专家。对于轻度拇外翻，87.7%的人建议手术治疗；围巾截骨术仍然是最常见的（49.4%），其次是Chevron（21.0%）和微创拇外翻矫正（14.8%）。微创采用者主要是职业生涯中期（83%，41-50岁）的大容量外科医生。对于严重拇外翻，95.1%倾向手术治疗；首选MTPJ关节融合术（50.6%孤立，11.1% Lapidus），而很少选择微创拇外翻矫正术（2.5%）。对于拇外翻和僵直，96%的患者选择MTPJ融合，最常见的是钢板螺钉内固定（45.1%）。与2015年相比，固定策略发生了变化，但手术选择基本保持不变。结论：尽管微创拇囊炎手术在全球范围内不断扩大，但瑞士外科医生仍然青睐已建立的开放技术，特别是Scarf截骨术和基于融合的策略。管理信息系统的采用仍然有限，并且集中在大量的、职业生涯中期的专家中，这表明一种谨慎的全国传播模式。证据水平：IV，调查研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.