Results at 3 years of Regnauld's technique for the treatment of hallux valgus and hallux rigidus in 147 cases

Abstract

Purpose

To assess radiological, clinical and functional results at 3 years’ evolution of patients subjected to surgical correction of hallux valgus and hallux rigidus by means of the Regnauld technique.

Materials and Methods

This is a descriptive retrospective study of 131 patients and 147 cases operated through the Regnauld technique between 2003 and 2006. One hundred and one females and 30 males were reviewed; 16 cases were bilateral. Mean age was 70 years. Mean follow-up was 3 years. Additional surgical maneuvers were used in 73 cases. Before and after surgery, an assessment was made of the patients’ clinical and functional status using both the AOFAS and a subjective scale; measurements were taken of the metatarsophalangeal (MTP), intermetatarsal (IM) and distal articular set angles (DASA).

Results

The degrees of correction achieved were 16.6° for the MTP angle, 2° for the IM angle and 1.7° for the DASA angle. Scores on the AOFAS scale improved from 39.6 to 85.4 points. On the subjective scale, 25% of cases rated their result as excellent, 68% as good and 2% as poor. As far as complications were concerned, there were 4.7% recurrences, 2% instances of moderate pain with no cases of hallux rigidus, hallux varus or infection. There were no reoperations.

Conclusions

The technique makes it possible to shorten the first phalanx, correct rotations, reduce the MTP and DASA angles, preserve the joint's congruence and integrity los MTPA y DASA and regain its function.

Resumen

Objetivo

Evaluar los resultados radiológicos, clínicos y funcionales a los 3 años de evolución en pacientes intervenidos quirúrgicamente para la corrección del hallux valgus y el hallux rigidus mediante la técnica de Regnauld.

Material y método

Estudio descriptivo retrospectivo de 131 pacientes (147 casos) intervenidos mediante la técnica de Regnauld entre los años 2003 y 2006. Se revisaron 101 mujeres, 30 varones, 16 bilaterales. Edad media de 70 años. Seguimiento medio de 3 años. Se asociaron otros gestos quirúrgicos en 73 casos. Antes y tras la cirugía se valoró el estado clínico y funcional con el test de la escala AOFAS (American Orthopaedic Foot & Ankle Society) y se midieron los ángulos metatarsofalángico (AMTF), intermetatarsal (IM) y DASA (distal articular set angle ‘ángulo articular distal’).

Resultados

Corrección del AMTF: 16,6°, del IM: 2° y del DASA: 1,7°. La puntuación en la escala AOFAS mejoró de 39,6 a 85,4.

Resultados

En la escala subjetiva, las valoraciones fueron excelentes (25%), buenas (68%), aceptables (5%) y malas (2%).

Resultados

En el 4,7% hubo recidivas; en el 2% hubo dolor moderado, sin casos de hallux rigidus, hallux varus ni infección; no hubo ninguna reintervención.

Conclusiones

Los resultados a medio plazo son satisfactorios, con un bajo porcentaje de complicaciones. La técnica permite acortar la primera falange, corregir rotaciones, reducir los AMTF y DASA, mantener la congruencia y la integridad articular y recuperar su funcionalidad.