Differenti metodi di intervento nella correzione dell'alluce valgo: valutazione dei risultati clinici

Aim. The aim of the study was to compare the mid term results of different surgical techniques for the correction of mild to moderate hallux valgus deformity. Methods. Two hundred and seven patients, monolaterally operated for correction of hallux valgus deformity at the Department of Orthopaedic Surgery of the University of Milan (Italy)-IRCCS Policlinico San Donato in the years 2000-2005, were retrospectively clinically re-evaluated. Different surgical techniques were employed (distal osteotomies and soft tissue procedures); proximal metatarsal and percutaneous osteotomies were excluded. Both American Orthopaedic Foot and Ankle Society (AOFAS) objective score and Foot Function Index (FFI) subjective index were used for clinical evaluation. Results. One hundred and nine patients were reviewed (96 females and 13 males) spanning the ages between 37 and 83 years; 34 of them have been treated by distal chevron osteotomy according to Austin, 33 by osteotomy according to Reverdin-Green, 17 have been operated on with the technique described by Regnauld, 16 by Lelievre operation and 9 have been treated according to Viladot (but this last cohort of patients was not considered in the statistic evaluation due to such a small number). Clinical results were very similar for the four aforementioned main techniques: for the Lelievre method only the global functional scores were slightly lower. Conclusion. From these results it is not possible to draw definite conclusions regarding the best surgical method for treatment of hallux valgus deformity; however, when a more aggressive technique is used, with sacrifice of the articular cartilage, the functional results are worse.