Comparison of the Type of Fixation of Akin Osteotomy

Liszka, Henryk; Gądek, Artur

doi:10.1177/1071100718816052

Cited by 19 publications

(27 citation statements)

References 27 publications

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“…The need of material removal as a minor complication after Akin osteotomy is reported in 1.5- 10 %. 6,8,18 Our study found a relatively high risk of material conflict, as 13 screws (15.1%) had to be removed because of soft tissue irritation in OS group.…”

Section: Discussionmentioning

confidence: 65%

Minimally Invasive vs Open Akin Osteotomy

et al. 2020

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Background: Minimally invasive techniques of Akin osteotomy have grown in popularity, as early results suggest faster recovery, earlier return to work, and minimized wound healing problems. Preserving lateral cortex integrity during first phalanx osteotomy thereby presents a challenge because of the lack of direct visual control. This retrospective comparative study investigated clinical and radiographic outcomes of minimally invasive and open Akin osteotomy with different fixation methods and analyzed whether or not intraoperative violation of the lateral cortex caused loss of correction or delayed bone healing. Methods: One hundred eighty-four patients (210 feet) with symptomatic hallux valgus and pathologic interphalangeal angle (IPA) of at least 10 degrees underwent surgery combined with Akin osteotomy. Minimally invasive Akin osteotomies were fixed in 124 feet with 2 crossing percutaneous K-wires and compared to 86 Akin osteotomies by open technique with double-threaded (head and shank) screw fixation. At 1 day and 6 and 12 weeks postoperatively, IPA and bony consolidation were radiographically and clinically assessed. Results: Mean preoperative IPA was 13.4 ± 3.6 degrees in minimally invasive (MI) and 13.3 ± 3.5 degrees in open surgery (OS) cases ( P > .05). Intraoperative breach of the lateral cortex occurred in 12 (13.9%) in OS and 64 (51.6%) in MI cases. Whereas the breach occurred in open technique mainly during manual correction by applying a medial closing force, it was caused predominantly by the use of the burr in minimally invasive technique. After 12 weeks, the mean IPA was 4.1 ± 1.4 degrees in MI and 4.8 ± 1.2 degrees in OS cases ( P > .05). Bony consolidation was complete after 6 and 12 weeks in OS and MI, respectively. Three deep infections occurred in the OS Group after Lapidus arthrodesis and 2 deep infections were registered in the MI Group after minimally invasive chevron and Akin osteotomy. The infections were not at the site of the Akin osteotomy. Conclusion: Breach of the lateral cortex did not impair bone healing or correction of IPA. Minimally invasive Akin osteotomy with K-wire fixation provided equivalent correction of IPA compared to open surgery with screw fixation. Level of Evidence: Level III, retrospective comparative series.

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Section: Discussionmentioning

confidence: 65%

Minimally Invasive vs Open Akin Osteotomy

et al. 2020

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Section: Discussionmentioning

confidence: 99%

“…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 The first author of the present study has developed a method of fixation employed in the Akin osteotomy of the proximal phalanx of the big toe by means of the percutaneous transosseous suture (ie, PTSA). Similarly, like open procedures, such an approach allows for reducing the costs of surgery and the risk of complications associated with using a screw, such as soft tissue irritation.…”

Section: Discussionmentioning

confidence: 99%

“…10,36,38,39 Although transosseous fixation of the Akin osteotomy seems to be fragile, recent studies have proven it to be equally effective and safe. 10,25,29,36,38,39…”

Section: Introductionmentioning

confidence: 99%

“…10,36,38,39 Although transosseous fixation of the Akin osteotomy seems to be fragile, recent studies have proven it to be equally effective and safe. 10,25,29,36,38,39 The first author of the present article has developed the method of percutaneous fixation of the Akin osteotomy using a transosseous suture; the procedure is performed in combination with the minimally invasive chevron osteotomy of the first metatarsal with 2 MICA screw fixation. The objective of the study was to present the operative technique and clinical and radiologic outcomes of the percutaneous transosseous suture fixation of the Akin osteotomy (PTSA) as compared to screw fixation, with both types of the procedures performed in the course of minimally invasive hallux valgus correction.…”

Section: Introductionmentioning

confidence: 99%

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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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Comment on an article: “Akin osteotomy: is the type of staple fixation relevant?”

Liszka

Gądek

2020

International Orthopaedics (SICOT)

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Comparison of the Type of Fixation of Akin Osteotomy

Cited by 19 publications

References 27 publications

Minimally Invasive vs Open Akin Osteotomy

Minimally Invasive vs Open Akin Osteotomy

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

Comment on an article: “Akin osteotomy: is the type of staple fixation relevant?”

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