Surgery for hallux valgus and hammertoe

• There is significant geographical variation in surgeries for hallux valgus and hammertoe.
• The number of surgeries has decreased by 43 % from 2015 to 2023.
• 80 % of the surgeries are performed on women.

The number of surgeries has decreased throughout the period, from 5,400 in 2015 to 3,100 in 2023. Women accounted for approximately 80 % of the surgeries in 2023, and the decline in the number of surgeries during the period is mainly due to fewer surgeries on women.

There is significant geographical variation in surgery rates. The catchment areas with the highest rates perform about three times as many surgeries per 1,000 inhabitants compared to the catchment areas with the fewest surgeries, classifying the variation as unwarranted. The catchment areas for Stavanger and Bergen HF have consistently low rates, while the catchment areas for Finnmark and UNN HF have consistently high rates.

More than half of the surgeries are performed in their own health trusts, and about 20 % are performed privately for the country as a whole, but there are significant differences between catchment areas. In 2023, about half of the surgeries were performed privately in the catchment areas for Finnmark and St. Olav HF, while no surgeries were performed privately in the catchment areas for Vestre Viken and Telemark HF.

The analysis is based on data from the Norwegian Patient Registry (NPR) for specialist healthcare services. The data includes activity in public hospitals, publicly funded private hospitals, and specialists in private practice under public funding contacts.

The sample consists of patients with a primary or secondary diagnosis of M20.1, M20.2, M20.3, M20.4, M20.5, or M20.6 in combination with:

• procedure code NHG09, NHG44, NHG46, NHG49, NHK17, NHK18, NHK57, or NHK58 in hospitals or
• fee code 134a, 134b, or 140d with a specialist

The place of treatment is divided into three categories:

• Local public, treated at one of the hospitals in the catchment area
• Other public, treated at a public hospital outside the catchment area
• Private, treated by a private hospital or a private specialist

In order to compare the catchment areas and between years, the rates have been adjusted for gender and age. The adjustment was done using the direct method with the population in 2023 as the reference population.

SKDE is solely responsible for the interpretation and presentation of the data provided by NPR. FHI/NPR is not responsible for analyses or interpretations based on the data.

All of the data used in the charts for this analysis can be downloaded as a CSV file.