A randomised controlled trial comparing post operative shoes following surgery of the first ray

INTERVENTION: intervention ‐ rigid flat soled post operative shoe ‐ The intervention group receive a rigid flat soled shoe. This is a stable device enabling near normal gait at the cost of putting pressure through the operated first ray. Patients will be given an information leaflet summarising the risks and benefits of a rigid flat post operative shoe when compared to the control which allows offloading of the operated forefoot and the expense of stability when mobilising. ‐ The only difference between groups will be the type of shoe they are given. All other operative techniques and post operative instructions will be standardised between groups. The shoe will be fitted in theatre by a trained member of the surgical team (specialist nurse or subspecialist foot and ankle fellow) and the patient will be mobilised on the ward by a trained physiotherapist and discharged when safely walking with the aid of two crutches. The patient information leaflet will include contact details of a member of the research team that they can contact if they have any queries or concerns. The shoe will be kept in place for 6 weeks and the only non standard post operative request will be for the patient to complete a patient reported outcome booklet containing the primary outcome measure and a secondary satisfaction measure. At one year all patients will be requested to complete a final radiograph which is not part of standard post operative care to assess for final radiographic outcome CONDITION: musculoskeletal‐ first ray surgery PRIMARY OUTCOME: 100 point visual analogue score for pain SECONDARY OUTCOME: modified 5 point likert satisfaction questionnaire radiographic analysis of correction for hallux valgus radiographic analysis of union for arthrodesis INCLUSION CRITERIA: primary surgery of the first ray‐ arthrodesis of the 1st metatarsophalangeal joint or scarf/akin osteotomy for hallux valgus