Die minimalinvasive Chevron- und Akin-Osteotomie (MICA)

Abstract

The method is very effective to treat even severe deformities with or without metatarsalgia. The amount of correction is similar to open procedures. We recommend cadaver training to become familiar with this technique. Thus, complications such as nerve, vessel or tendon injuries can be avoided. The intraoperative radiation exposure remains significantly elevated even for experienced surgeons. In addition to the aesthetic benefits, there is less soft tissue traumatization compared to conventional open procedures. There is no need of bloodlessness. The minimally invasive Chevron and Akin osteotomy is a safe and powerful technique for the treatment of hallux valgus deformity.

Clinical and Radiographic Outcomes of Percutaneous Chevron-Akin Osteotomies for the Correction of Hallux Valgus Deformity

“…30 This procedure was popularized and refined in Europe in 2008 by Drs Redfern and Vernois. 1,30 It has since grown in popularity because of its minimally invasive nature, which offers reduced disruption of the soft tissues and purported benefits such as improved wound healing, fewer postoperative complications, higher patient satisfaction, and a more aesthetically pleasing results. 1,20,23 Several studies have assessed outcomes of MICA by reporting on radiographic measurements (IMA and HVA), the American Orthopaedic Foot & Ankle Society score, pain, patient satisfaction, range of motion, and complications, but most were limited in cohort size.…”

Open vs Minimally Invasive Scarf Osteotomy for Hallux Valgus Correction: A Randomized Controlled Trial

“…A variety of operative techniques as Lapidus procedure, 41 chevron osteotomy, 2 or scarf osteotomy 6 among others have been proposed in the treatment of HV. However, there is no consensus on which is the most effective technique.…”

“…18 A third generation of MI techniques have been developed based on the open chevron osteotomy stabilized with screw fixation. 11 Although different versions of the MI chevron osteotomy have been described, the minimally invasive chevron-Akin (MICA) 2,42 and the percutaneous chevron-Akin (PECA) 27 are the most popular.…”

Kramer and Chevron Osteotomy for Hallux Valgus Deformity – Retrospective Comparison of Functional and Radiological Results

“…During this procedure a 60-80°V-shaped osteotomy is made in the distal first metatarsal, and a third to half of the capital fragment is pushed laterally, thus correcting the hallux valgus angle [9]. Recent studies show that larger displacement sections can heal without complications, thus increasing the significance of minimally-invasive surgical techniques [10]. In addition, the exostosis is removed medially from the head of the first metatarsal, and the capsule is gathered so that the large toe is orthograde at the end of the operation.…”

“…Only a small fragment screw is required [10]. Performing an additional lateral release with an incongruent basal joint is recommended and leads to better clinical outcome and radiologically better postoperative positioning of the sesamoids [10,11]. A Kramer osteotomy follows a similar principle [12].…”