REGNAULD TECHNIQUE IN THE TREATMENT OF HALLUX VALGUS: RESULTS IN 147 CASES AT 2 YEARS FOLLOW-UP

Abstract

Introduction and Objectives: The technique modified by Regnauld makes it possible to correct the MTP angle and the DASA, shorten the first phalange preserving the MTP joint, and its articular congruence and functionality. Assessment of results at 2 years follow-up of 147 cases treated with this technique.

Materials and Methods: Causes: Hallux Valgus 111; Hallux Rigidus 36. Sex: Women 114, men 33. mean age 70 years. Associated surgery: Proximal chevron-type osteotomy of the first MTT: 23; Scarft-type diaphyseal osteotomy: 1; osteotomy of the base of the first MTT: 11; double osteotomy: 5; subcapital Weils-type osteotomy: 15. Preoperative AOFAS test score 39.6. Mean follow-up 2.3 years. Pre and postoperative measurement of metatarsophalangeal angles. Postoperative assessment at 1 month, 6 m, 1 year and 2 years with X-ray, AOFAS scale.

Results: Postoperative assessment using the AOFAS scale: < 1 month: 65, < 6 months: 78, < 1 year: 89, < 2 year: 82. AOFAS scale at 2 years: Moderate pain 2%. Narrow shoes 11%. Moderate MTP restriction 35%. Severe MTP restriction 2%. Infrequent mobility with severe IP restriction 9%. Asymptomatic malalignment 5%. Subjective assessment: Very satisfied 25%. Satisfied 68%. Not very satisfied 5% (occasional pain). Unsatisfied 2% (daily pain). The evolution of the values of the MTP angle were: preoperative MTP angle 34.7°, MTP angle 4 weeks postoperatively 8.1°, MTP angle at 1 year 14.7°, MTP angle at 2 years18.1°.

Discussion and Conclusions: Satisfactory results (93%). This technique corrects the MTP angle, preserves the MTF joint and makes it possible to associate with it other surgical techniques to modify the intermetatarsal angle. By preserving the MTP joint we prevent early evolution of hallux rigidus. Very little loss of MTP correction at 2 years (10°), with no clinical correlation.