A Modified Suture Technique for Fixation of the Akin Osteotomy

Tan, Ken Jin

doi:10.1053/j.jfas.2012.11.010

Cited by 19 publications

(16 citation statements)

References 6 publications

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“…18,23,40 The literature presents reports describing very good results of the Akin osteotomy fixation performed as an open procedure using a single- or double-channel transosseous suture. 10,25,29,36,38,39…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Transosseous Suture Fixation of the Akin Osteotomy and Minimally Invasive Chevron for Correction of Hallux Valgus

Liszka

Gądek

2020

Foot Ankle Int.

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Background: The objective of the study was evaluation of the clinical and radiologic outcomes and complications following the minimally invasive chevron procedure employing the Akin osteotomy with percutaneous transosseous suture as compared to screw fixation. Methods: Between 2018 and 2019, the authors performed 103 minimally invasive chevron (MIC) with Akin osteotomies. In 54 patients, the Akin osteotomy was performed with screw stabilization (group A), and in 49 with percutaneous transosseous suture (group B). Preoperatively and 1 year later, the authors employed anteroposterior and lateral weightbearing radiographs of the feet to evaluate interphalangeal angle (IPA), distal phalangeal articular angle (DPAA), proximal phalangeal articular angle (PPAA), intermetatarsal angle (IMA), hallux valgus angle (HVA), and functional result using the American Orthopaedic Foot & Ankle Society (AOFAS) hallux-metatarsophalangeal-interphalangeal scale. Furthermore, all additional procedures and complications were recorded. Results: Both groups demonstrated a statistically significant decrease of the value of HVA (group A: from 34.1° to 14.0°, group B: from 33.6° to 13.0°), DPAA (group A: from 12.1° to 4.0°, group B: from 11.5° to 3.4°), PPAA (group A: from 4.6° to 1.7°, group B: from 4.3° to 1.5°), IMA (group A: from 15.1° to 8.0°, group B: from 14.7° to 7.5°) and IPA (group A: from 14.1° to 6.3°, group B: from 12.9° to 5.1°). Functional improvement as measured using the AOFAS scale was achieved in both groups (group A: from 42 to 90 points, group B: from 40 to 89 points). No cases of bone nonunion or delayed union and permanent damage to the medial dorsal cutaneous nerve were seen. Two group B patients underwent conversion of the fixation of the Akin osteotomy to screws, 3 patients had their MICA screws and 1 Akin screw removed in the outpatient setting. Conclusion: The minimally invasive chevron osteotomy with transosseous suture stabilization of the Akin osteotomy was a safe method with good functional results that were comparable to the outcomes achieved when using screw fixation. Level of Evidence: Level III, retrospective comparative study.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Transosseous Suture Fixation of the Akin Osteotomy and Minimally Invasive Chevron for Correction of Hallux Valgus

Liszka

Gądek

2020

Foot Ankle Int.

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“…1 Over the past decades, internal fixation methods including hardware such as the K-wire, wire loop, screw, or staple have been developed. 2,5,8,[9][10][11][13][14][15][17][18][19][20]23,[26][27][28][30][31][32] Recently, staple or screw fixation has been preferred by some surgeons. 2,7,8,16,21,24 Using a staple can achieve good compression between bony fragments.…”

Section: Discussionmentioning

confidence: 99%

“…25,32 The main indication to perform the Akin osteotomy is an increased hallux IPA, with the procedure aimed at achieving proper alignment of the hallux. 24,26,30 Usually, it is combined with other balancing procedures, such as any type of first metatarsal osteotomy or Lapidus arthrodesis. 4,7,22,25,26,30…”

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Comparison of the Type of Fixation of Akin Osteotomy

Liszka

Gądek

2018

Foot Ankle Int.

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Background: The objective of the study was to assess the influence of the type of fixation of the Akin osteotomy when used during hallux valgus surgery. Methods: Between 2013 and 2016, we performed 138 Akin osteotomy procedures employing a staple (group A, 43 patients), screw (group B, 47 patients), and single or double transosseous suture stabilization (group C, 48 patients). We assessed the pre- and postoperative interphalangeal angle (IPA), hallux valgus angle (HVA), and intermetatarsal angle (IMA) on dorsoplantar and lateral foot weightbearing x-rays and used the American Orthopaedic Foot & Ankle Society (AOFAS) hallux-metatarsophalangeal-interphalangeal scale for preoperative and 12-month postoperative follow-up clinical assessment. All the complications and costs of implant usage were recorded. Results: In all the groups, the average HVA (A: from 33.4 to 13.1 degrees; B: from 32.8 to 14.1 degrees; C: from 31.9 to 12.9 degrees), IMA (A: from 14.4 to 7.2 degrees; B: from 13.9 to 6.9 degrees; C: from 14.5 to 7.1 degrees), and IPA (A: from 12.1 to 5.6 degrees; B: from 11.7 to 6.0 degrees; C: from 12.5 to 5.9 degrees) decreased. The average AOFAS score improved in groups A (from 45 to 91 points), B (from 42 to 90 points), and C (from 42 to 91 points). We observed 1 recurrence after the single-tunnel suture fixation, 1 prominent screw, and 1 staple soft tissue irritation. We did not find a delayed union or nonunion. Conclusion: The suture fixation of the Akin osteotomy provides results comparable to other forms of stabilization. The procedure is cost saving and helps to avoid hardware-related complications. Despite the type of bunion surgery used, fixation of the Akin osteotomy with suture was as good as more expensive and potentially more complicated fixation methods. Level of Evidence: Level III, retrospective comparative study.

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“…This is a reliable osteotomy for correction of hallux valgus interphalangeus and rotational deformity associated with hallux valgus. 10 The intramedullary plate continues to be a reliable method of metatarsal osteotomy fixation intraoperative and postoperatively. It remains our fixation method of choice because of its ease of use, reliable healing and maintenance of correction (even in noncompliant patients), and reproducible results.…”

Section: Discussionmentioning

confidence: 99%

Intraosseous Sliding Plate Fixation Used in Double Osteotomy Bunionectomy

et al. 2018

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Hallux valgus is a very common orthopedic problem. In patients with pain not responsive to footwear and activity modification, chevron distal metatarsal osteotomy bunionectomy is a commonly performed and highly successful procedure for the treatment of mild and moderate hallux valgus. 3,4,6 We have previously reported our results in a prospective study of 57 patients who underwent chevron bunionectomy in which the metatarsal osteotomy was stabilized with an intramedullary plate system, 3 which secures the metatarsal shaft to the first metatarsal head after lateral displacement of the metatarsal head. The intramedullary device is secured to the head and shaft with 2.4-mm screws. Although our results with this technique were good, we wanted to evaluate the potential added benefit of performing an Akin osteotomy of the proximal phalanx in addition to the metatarsal osteotomy. This is the double osteotomy bunionectomy. When we first started performing this procedure, we observed that we were able to achieve a better cosmetic result with less aggressive tightening of the medial capsule and better range of motion of the first metatarsophalangeal (MTP) joint. Although most series of bunionectomies have good patient satisfaction, we wanted to see if the double osteotomy bunionectomy technique would result in a higher degree of patient satisfaction and better cosmesis. The purpose of this study was to prospectively evaluate the results of double osteotomy bunionectomy in a consecutive group of 138 patients operated on by a single surgeon over a 2-year period of time. Methods We performed double osteotomy bunionectomies on 138 consecutive patients (145 feet) between June 13, 2013, and March 18, 2015. All operative procedures were performed 800635F AIXXX10.

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A Modified Suture Technique for Fixation of the Akin Osteotomy

Cited by 19 publications

References 6 publications

Percutaneous Transosseous Suture Fixation of the Akin Osteotomy and Minimally Invasive Chevron for Correction of Hallux Valgus

Percutaneous Transosseous Suture Fixation of the Akin Osteotomy and Minimally Invasive Chevron for Correction of Hallux Valgus

Comparison of the Type of Fixation of Akin Osteotomy

Intraosseous Sliding Plate Fixation Used in Double Osteotomy Bunionectomy

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