[Evaluation of radiographic results in geriatric population with moderate to severe degree hallux valgus intervened with surgical technique of Lelièvre and Vidalot]

BACKGROUND

Hallux valgus (HV) defines a valgo deviation from the metatarsophalangeal joint and in a varo of the first metatarsal. The surgery aims to restore joint congruence, correct deformity and decrease pain. There is little literature on the results in the geriatric population. The purpose of this study is intended to demonstrate that the open surgical technique of Lelièvre and Vidalot achieves acceptable radiographic results in that population.

MATERIAL AND METHODS

68 patients between 60 and 85 years of age were involved with Lelièvre Technique and Vidalot for moderate to severe HV of Isham, between January 2014 and January 2017. Immediate postoperative and six month radiographs were evaluated with conventional radiometry for this condition; All measurements were made in digital system. The data was entered in Microsoft Excel. p values 0.05 were considered statistically significant.

RESULTS

Out of 68 patients (54 women and 14 men), average age 68.0 years. 12 had bilateral concern. 28 second finger claw. The metatarsphasopalangic angle with a preoperative mean was 36.6o, increased by 100% of cases of intermetatarsal angle 1-2, with a correlation p 0.05 between intermetatarsal angle and metatarsal angle increase. Immediate and six-month post-surgical results with a correlation of p = 0.3107.

CONCLUSIONS

The treatment of moderate to severe HV in our geriatric population under technique Lelièvre and Vidalot achieves an acceptable correction demonstrated radiographically in the immediate postoperative period and at six month, this translates a viable option of surgical treatment in these population.

[Installed Capacity Perception Survey for the Training of Residents Program in Orthopedics and Care Needs in Acute and Chronic Musculoskeletal Pathology in Mexico]

INTRODUCTION

It is essential that orthopaedic resident physicians be highly proficient in all aspects, considering the balance between supply, demand, need and context. Fundamental to identify the capacity and quality installed for their training in Mexico.

MATERIAL AND METHODS

Observational Study, transverse, non-probabilistic sampling-conglomerates, in two phases. The instrument has 8 domains, 57 variables and 4,867 items. 60 graduate professors of 20 states, 50 hospital sites, 22 university programs.

RESULTS

1,038 years of experience (collective intelligence), 17 years of experience/teacher (01 to 50 years). Identified: acute pathology 30 (2 to 90%), chronic pathology 30 (5 to 96%), patients 15 years, 10 (3 to 30%), patients between 15 and 65 years, 47 (2 to 78%), patients 65 years, 20 (2 to 60%), number of beds/seat 20 (2 to 510), number of clinics 3 (1 to 48), number of surgical procedures/headquarters per year at the national level, was 960 (50 to 24,650). The national average per resident doctor is 362 surgeries/year with 1,450 surgical times/year.

CONCLUSIONS

The needs and resources for the training of physicians specializing in orthopedics/traumatology are highly heterogeneous, so it should be adapted to the epidemiological needs of the region of influence, in an area of epidemiological transition. 62.2% expressed not having or have bad academic and scientific infrastructure at its headquarters, more than 50% without rotation overseas and 90% without regular scientific production.