Modern Techniques in Hallux Abducto Valgus Surgery

Bussewitz, Bradly W.; Levar, Tim; Hyer, Christopher F.

doi:10.1016/j.cpm.2011.03.005

Cited by 11 publications

(13 citation statements)

References 38 publications

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“…It is widely used as an adjunct after a more proximal metatarsal osteotomy. 1,3,9,10,13 It is not intended to be performed in isolation for the correction of hallux valgus because it can exacerbate the deformity. 9,13 Specifically, the Akin osteotomy is indicated for persistent interphalangeal angle deformity after correction of intermetatarsal angle, distal metatarsal articular angle, and hallux valgus angle by soft tissue balancing and osseous procedures.…”

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confidence: 99%

Staple Fixation for Akin Proximal Phalangeal Osteotomy in the Treatment of Hallux Valgus Interphalangeus

et al. 2014

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Staple Fixation for Akin Proximal Phalangeal Osteotomy in the Treatment of Hallux Valgus Interphalangeus

et al. 2014

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“…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. Moreover, a staple helps to avoid stress risers.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, a staple helps to avoid stress risers. 24 The staple procedure usually requires a shorter time to perform than the suture technique, 7 and it seems to be less technically demanding. 24 However, using necessary instrumentation, such as a mallet, may lead to fracture.…”

Section: Discussionmentioning

confidence: 99%

“…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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“…K-wires require removal and can get infected. 7,13,17,24 Screws ensure good compression; however, their use may be technically demanding and lead to stress risers. 10 Staples provide initial dynamic compression with a tendency to decrease with the distance from the insertion site.…”

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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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