Psychological implications in percutaneous hallux valgus surgery

BACKGROUND: The aim of this study was to evaluate psychological implications in post- operative pain perception in hallux valgus surgery in patients who had already undergone contralateral foot surgery. METHODS: This study included 42 patients treated with percutaneous surgery for bilateral hallux valgus in two different times (40 females and 2 males; mean-age at the 1st surgery: 55,7 years; mean-age at the 2nd surgery: 56,7 years). All patients were administered Visual Analog Scale (VAS) one week after surgery to judge post-operative pain and evaluated clinically to assess post-operative convalescence. They were randomly divided in 2 groups: in the group A patients haven’t received further indications about post-operative pain in contralateral surgery; in the group B patients have been informed that post-operative pain would have been worse in contralateral surgery. Both groups received the same anesthesiological and pharmacological support in the peri-operative period. RESULTS: The VAS score was 1.03 and 1.55 after first surgery; 4.19 and 0.5 after second surgery for group A and group B respectively. All statistical analysis were performed using SPSS software (SPSS Inc., IL., USA). All patients reported no pain 7 days after surgery. No significant clinical variation was reported. CONCLUSIONS: In this study we observed the great importance of psychological implications in pain perception in patients undergoing foot surgery. The role of the surgeon is not only related to technical skills but it’s also conditioned by his/her ability to drive patients individual perception of post-operative outcome.