The association between surgeon grade and clinical outcome in fourth-generation minimally invasive hallux valgus surgery.

BACKGROUND: Fourth-generation minimally invasive techniques for hallux valgus correction have demonstrated positive clinical outcomes. However, incorporation into orthopaedic training remains unexplored. This study evaluated whether orthopaedic trainees, operating under direct supervision of an experienced MIS surgeon, achieve comparable outcomes to consultant-performed procedures. METHODS: A retrospective study of 100 MIS hallux valgus corrections compared consultant-performed (n = 50) and trainee-performed (n = 50) groups. Radiographic parameters (HVA, IMA, DMAA) and PROMs (MOXFQ, EQ-5D-5L) were compared. RESULTS: 47 consultant and 49 trainee procedures were analysed. Both groups demonstrated significant improvement in all radiographic parameters, MOXFQ and EQ-5D-5L index (P < 0.01). No significant differences were observed between consultant- and trainee-performed groups for postoperative HVA, IMA, MOXFQ, or EQ-5D-5L scores (P > 0.05). Complication rates were comparable (12 each, P > 0.05). CONCLUSION: Trainees performing MIS hallux valgus correction under direct supervision achieved comparable radiographic correction, patient-reported outcomes, and complication rates to those of a consultant surgeon. LEVEL OF EVIDENCE: Level III, Comparative study.