Double First Metatarsal and Akin Osteotomy for Severe Hallux Valgus

Al-Nammari, Shafic Said; Christofi, T.; Clark, Callum

doi:10.1177/1071100715589173

Cited by 31 publications

(32 citation statements)

References 49 publications

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“…A tarsometatarsal arthrodesis with two crossed screws may be added in cases, where hypermobility of the first tarsometatarsal joint is observed during clinical examination [ 8 – 10 ]. A phalangeal Akin osteotomy with one screw can also be used as an additional procedure to obtain more angular and rotational correction [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

The influence of the number of screws and additional surgical procedures on outcome in hallux valgus treatment

et al. 2018

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BackgroundSurgical treatment of hallux valgus (HV) is one of the major flagships of orthopedic surgeons. Due to relatively unsatisfactory radiological and clinical outcomes, the search for the best surgical technique and causes for unsatisfactory outcomes continues. The objective was to investigate associations of the number of screws and additional surgical techniques for HV with radiological and clinical outcome after reversed L-shaped osteotomy (ReveL).MethodsA retrospective cohort study of adults from a single University Hospital between 2004 and 2013 was performed. The primary exposure was the number of screws (one vs two) used for osseous fixation after ReveL. The secondary exposure was an additional surgical technique for HV (e.g., Akin osteotomy). The primary outcome was a radiological recurrence of HV (HV angle (HVA) > 15°) at last follow-up. The secondary outcomes were limited patient satisfaction, complication, revision surgery, and elective hardware removal. Odds ratio (OR) and 95% confidence interval (CI) were estimated by logistic regression adjusting for confounders.ResultsThe recurrence was 45% less likely with the use of one screw, independent of age, sex, additional technique, and preoperative HVA (odds ratio (ORadjusted) = 0.55 [95% CI 0.30–0.98], p = 0.043). The recurrence was 162% more likely with an additional surgical technique for HV (ORadjusted = 2.62 [1.24–5.52], p = 0.011).ConclusionIn ReveL for HV, a single screw (instead of two screws) may be sufficient enough for a similar or even better outcome, which may also reduce costs. Additional surgical procedures for HV may be refrained from if possible. Due to limitations of a retrospective study, results may need validation with clinical trials.

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Section: Introductionmentioning

confidence: 99%

The influence of the number of screws and additional surgical procedures on outcome in hallux valgus treatment

et al. 2018

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“…Akin osteotomy was recently shown to be an indispensable procedure in two osteotomies of double or bifocal osteotomies of the first metatarsal. 31 Because our study demonstrated that early initiation of ZOL had no adverse effects on fusion of the Lapidus arthrodesis or healing of the Akin osteotomy, it is reasonable to consider that early initiation of ZOL can also be applied to other surgeries for moderate HV such as Ludloff osteotomy and chevron osteotomy.…”

Section: Discussionmentioning

confidence: 84%

“…Akin osteotomy, the most widely used type of proximal phalanx osteotomy, is a well-known adjunct to other procedures in patients with an increased interphalangeal angle or distal articular set angle. 5 , 7 …”

Section: Introductionmentioning

confidence: 99%

Early initiation of zoledronic acid does not impact bone healing or clinical outcomes of hallux valgus orthomorphia

Yang

2018

J Int Med Res

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ObjectiveThis prospective randomized controlled study was performed to determine whether early drug use for osteoporosis impacts bone healing after orthomorphic surgery for hallux valgus (HV) in menopausal patients with osteoporosis.MethodsThis study included 113 consecutive patients with osteoporosis who underwent a combination of Lapidus arthrodesis and Akin osteotomy for treatment of HV. The patients were randomly divided into a zoledronic acid (ZOL) group (5-mg intravenous injection of ZOL, n = 56) and a placebo group (n = 57); both ZOL and placebo were administered 1 week postoperatively. Radiographs were taken preoperatively and at 1, 6, 8, 10, and 12 weeks postoperatively to record the time of the first tarsometatarsal joint (FTJ) fusion and Akin osteotomy site healing. Clinical outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) scoring system 24 weeks after surgery.ResultsThere were no statistically significant differences in the FTJ fusion time after Lapidus arthrodesis, healing time after Akin osteotomy, or postoperative AOFAS scores between the two groups.ConclusionEarly initiation of ZOL does not impact the bone healing or clinical outcomes of orthomorphic surgery for HV in postmenopausal women diagnosed with osteoporosis after a combination of Lapidus arthrodesis and Akin osteotomy.

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“…Gegebenenfalls ist eine Korrektur des DMAA (> 15°) erforderlich und sollte bei der Wahl der Korrekturosteotomie berücksichtigt werden [1]. Zudem sollte eine ergänzende Korrektur bei pathologisch verändertem IPW (Hallux valgus interphalangeus) (> 5°) überlegt werden (Akin-Osteotomie) [9].…”

Section: Operativunclassified

Hallux valgus

Heinze¹

2019

Arthritis und Rheuma

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ZUSAMMENFASSUNGAufgrund der hohen Prävalenz und der vielschichtigen Ätiologie ist der Hallux valgus ein vieldiskutiertes Thema mit vielen verschiedenen Therapieoptionen. Ziel sowohl operativer als auch konservativer Therapien ist die schmerzfreie Mobilität des Patienten, um eine Verbesserung der Lebensqualität zu erreichen. Eine gute Kommunikation zwischen orthopädietechnischer und ärztlicher Betreuung ist eine Grundvoraussetzung sowohl für die konservative Therapie als auch für die postoperative Nachbehandlung. Bei symptomatischem Hallux valgus ist eine Progression der Fehlstellung ohne operative Intervention zu erwarten. Die konservative Therapie bietet keine ursachenorientierte Therapie, es kann jedoch eine Beschwerdebesserung erreicht werden.

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Double First Metatarsal and Akin Osteotomy for Severe Hallux Valgus

Abstract: Level IV, retrospective case series.

Cited by 31 publications

References 49 publications

The influence of the number of screws and additional surgical procedures on outcome in hallux valgus treatment

The influence of the number of screws and additional surgical procedures on outcome in hallux valgus treatment

Early initiation of zoledronic acid does not impact bone healing or clinical outcomes of hallux valgus orthomorphia

Hallux valgus

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