Effect of bunion surgery on fall risk: A nationwide database study of 127,990 older adults with hallux valgus

Authors

• Adam Fleischer, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine, Chicago, Illinois, USA, adam.fleischer@rosalindfranklin.edu.
• Rachel Albright, Department of Surgery, Stamford Health Medical Group, Stamford, Connecticut, USA.
• Zalak Bhatt, Weil Foot and Ankle Institute, Mount Prospect, Illinois, USA.
• Neveen Abuali, Advocate Health - MidwestFollow
• Dyane Tower, American Podiatric Medical Association, Bethesda, Maryland, USA.
• Lowell Weil, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine, Chicago, Illinois, USA.

Recommended Citation

Fleischer A, Albright R, Bhatt Z, Abuali N, Tower D, Weil L Jr. Effect of Bunion Surgery on Fall Risk: A Nationwide Database Study of 127,990 Older Adults with Hallux Valgus. Gerontology. Published online April 6, 2026. doi:10.1159/000551884

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Introduction: The presence of a bunion (hallux valgus) deformity is a recognized risk factor for falls among older adults; however, it is uncertain whether surgical correction of the foot deformity can help mitigate this risk.

Methods: We conducted a retrospective cohort study of US adults aged 50 years and over with hallux valgus using commercial, state, and federal healthcare claims obtained from a national database (PearlDiver, Inc.). Patients who underwent bunion surgery were compared to those treated nonoperatively for their bunion deformities from January 2011 to April 2022. Claims-based falls (all-cause) were tracked using diagnosis codes for up to 11 years. Group differences in fall risk were examined using both 1-year and long-term adjusted hazard ratios (aHRs) and corresponding absolute risks.

Results: There were 127,990 people diagnosed with hallux valgus and 17,406 (13.6%) underwent surgery. The median follow-up time was 2,905 and 2,298 days for the surgery and non-surgery groups, respectively. A smaller proportion of people fell in the surgery versus non-surgery group (5 vs. 8% at 1 year; 16 vs. 21% over total follow-up). Furthermore, after controlling for important covariates, patients who underwent bunion surgery were 16% less likely to fall in the first year (aHR 0.84, 95% CI: 0.76-0.92) and 42% less likely to fall over the 11-year follow-up (aHR 0.58, 95% CI: 0.52-0.63) compared to those with uncorrected hallux valgus deformity.

Conclusion: Among older adults in whom surgery is already indicated, a potential ancillary benefit may be a reduction in injurious falls over time.

Type

Article

PubMed ID

41941376