{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:12:27Z","timestamp":1777612347414,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T00:00:00Z","timestamp":1701993600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is little available information regarding the difference in outcomes between severe hallux valgus (S-HV), defined as 40 degrees\u2009\u2264\u2009hallux valgus angle (HVA)\u2009&lt;\u200950 degrees, and what we consider to be \u201csuper-severe HV\u201d (SS-HV), defined as &gt;50 degrees, following a proximal metatarsal osteotomy. We aimed to retrospectively compare the outcomes of a proximal metatarsal osteotomy in S- and SS-HV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The series consisted of 57 female patients (57 feet) treated with a proximal supination osteotomy for symptomatic S- and SS-HV (33 and 24 feet, respectively). The outcome measures included radiographic parameters and for 45 patients included the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) score, and a visual analog scale pain score (VAS-PS) preoperatively and at a minimum follow-up of 12\u2009months with a median of 26\u2009months. No significant differences were found in age, body mass index, and the duration of follow-up between patients with S-HV and SS-HV ( P\u2009&gt;\u2009.10 for all comparisons) with the numbers available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Preoperative HVA in patients with S- and SS-HV was significantly improved at the final follow-up ( P\u2009&lt;\u2009.0001 for both comparisons). No significant differences in postoperative HVA and IMA were observed between patients with S- and SS-HV (P\u2009=\u2009.51 and .50, respectively). All 5 preoperative subscale scores of SAFE-Q in patients with S- and SS-HV significantly improved postoperatively ( P\u2009&lt;\u2009.01 for all comparisons). Preoperative VAS-PS in patients with S- and SS-HV significantly improved postoperatively ( P\u2009&lt;\u2009.0001 and &lt;.009, respectively). There were no significant differences in preoperative and postoperative scores of all the SAFE-Q subscales and VAS-PS between patients with S-HV and SS-HV ( P\u2009&gt;\u2009.10 for all) with the numbers available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We found for this patient group that a proximal supination osteotomy can achieve a large correction for SS-HV as well as S-HV and significantly improve radiologic and clinical outcomes in SS-HV. The outcomes between patients with S- and SS-HV were not different in this series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10711007231210809","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T06:26:45Z","timestamp":1702016805000},"page":"141-149","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Proximal Supination Osteotomy for Hallux Valgus: Comparison of Clinical and Radiologic Outcomes for the Most Severe Deformities"],"prefix":"10.1177","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5854-8445","authenticated-orcid":false,"given":"Ryuzo","family":"Okuda","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Rakusai-Shimizu Hospital, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kei","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rakusai-Shimizu Hospital, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Shima","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,12,8]]},"reference":[{"key":"bibr1-10711007231210809","doi-asserted-by":"publisher","DOI":"10.1177\/1071100715589173"},{"key":"bibr2-10711007231210809","doi-asserted-by":"publisher","DOI":"10.1177\/1071100712472489"},{"key":"bibr3-10711007231210809","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.1154"},{"key":"bibr4-10711007231210809","first-page":"357","volume":"46","author":"Coughlin MJ.","year":"1997","journal-title":"Instr Course Lect"},{"key":"bibr5-10711007231210809","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.01139"},{"key":"bibr6-10711007231210809","unstructured":"Coughlin MJ, Saltzman CL, Anderson RB. 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