Abstract
Aim Pressure on inpatient beds can lead to high cancellation rates for inpatient elective orthopaedic surgery. The use of day surgery facilities is one way to overcome this problem. We set out to assess patient satisfaction after Scarf osteotomy, as a day case procedure, to help determine whether this is a valid routine practice.
Method Twenty-six consecutive patients (25 female and 1 male) undergoing Scarf metatarsal osteotomy, lateral release, medial capsulorraphy, and Akin osteotomy were prospectively followed up. Three patients had bilateral procedures resulting in 29 operations being performed. All had their surgery under midfoot block with intravenous sedation administered by an anaesthetist. All patients were discharged on the day of surgery with oral analgesia and contact details of the on-call orthopaedic registrar. A telephone interview and questionnaire were performed on day 3 and day 7 post-operatively.
Results Post-operative pain: seven patients (24%) had no pain, 15 (51%) mild pain, five (17%) moderate pain and two (6%) had episodes of severe pain. Twenty-eight patients (96%) were satisfied with their level of postoperative analgesia. Twenty-eight patients (96%) would have the surgery as a day case again. One patient would not due to post-operative nausea and vomiting.
Post-operative problems experienced by patients: 17 patients (58%) had no problems, six (20%) felt that their pain was a problem, five (17%) experienced bleeding/bruising and one (3%) felt faint.
Survey of medical services contacted by patients: 26 (89%) contacted no-one, one (3%) day surgery unit staff, two (3%) their GP and one (3%) the hospital.
Significance Scarf osteotomy can be successfully performed under midfoot block with a high degree of patient satisfaction. This has the potential to reduce cancellations due to inpatient bed shortage.
Correspondence should be addressed to BOFSS, c/o Wrightington Wigan and Leigh NHS Trust, Hall Lane, Appley Bridge, Wigan, Lancashire WN7 9EP.
