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 42% from 2015 to 2024
• 80% of the surgeries are performed on women

The number of operations has declined throughout the entire period, from 5,400 in 2015 to 3,150 in 2024. Most of the decrease occurred around the pandemic year of 2020. The number of operations in 2024 is approximately at the same level as in 2020. Female patients accounted for around 80% of operations in 2024, and the decline in the number of operations over the period is mainly due to a reduction in procedures performed on women.

There is considerable geographical variation in operation rates. The catchment area with the highest rate performs nearly five times as many operations per 1,000 inhabitants compared with the area with the lowest rate. The catchment areas for Stavanger and Fonna had the lowest rates in 2024, while those for UNN and Finnmark had the highest.

Excluding the two catchment areas with the highest and lowest rates, the variation narrows to a highest rate that is 1.5 times the lowest.

Nearly 20% of operations nationwide are performed by private providers, but there are substantial differences between catchment areas. In 2024, nearly half of all operations in the St. Olav catchment area were carried out privately, whereas almost none were performed privately in the catchment areas for Bergen, Fonna, and Telemark.

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.