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International Orthopaedics

, Volume 42, Issue 1, pp 117–124 | Cite as

Percutaneous minimally invasive Akin osteotomy in hallux valgus interphalangeus: a case series

  • Gerhard KaufmannEmail author
  • Martin Handle
  • Michael Liebensteiner
  • Matthias Braito
  • Dietmar Dammerer
Original Paper

Abstract

Purpose

Phalangeal Akin osteotomy of the greater toe is a frequently used surgical procedure for correcting hallux valgus interphalangeus deformity. However, previous research did not investigate percutaneous techniques of the Akin osteotomy. It was the aim of this study to investigate feasibility, corrective potential, and safety of a percutaneous minimally invasive Akin osteotomy.

Methods

We present a series of 81 feet, in which a percutaneous Akin technique was performed using a high-speed burr but no fixation device. The most important outcome parameters were determined as the proximal to distal phalangeal articular angle (PDPAA) (corrective effect of the osteotomy), the osteotomy healing (full, partly, no visibility of the osteotomy gap), and the integrity of the lateral cortical hinge.

Results

With regard to the main hypothesis we found significant changes in the PDPAA over the whole period of time (p < 0.001). Post-hoc tests determined that the PDPAA changed from 10° pre-operatively (Md, IQR 4.3) to 2.3° post-operatively (Md, IQR 3.7) (p < 0.001). Post-operatively no significant changes in PDPAA were found within the first six weeks and from six weeks to three months (no loss of correction). Osteotomy healing was satisfactory as well. Three months post-operatively, there were no patients with a fully visible osteotomy gap, 28.3% with a partly visible osteotomy gap, and 71.7% had no visible gap. Interestingly, we could not observe a statistically significant correlation between bone healing and the integrity of the lateral cortical hinge.

Conclusion

From our findings we conclude that the minimally invasive Akin osteotomy without osseous fixation provides effective deformity correction without significant loss of correction thereafter. This procedure appears to be safe with regard to osseous healing. Surprisingly, the healing process of the osteotomy showed no dependence on the integrity of the lateral cortical hinge.

Levels of Evidence: Therapeutic, Level IV, retrospective case series.

Keywords

Hallux valgus interphalangeus Akin osteotomy Minimally invasive Phalangeal Percutaneous 

Notes

Acknowledgments

The authors would like to thank Mrs. Margreiter M. for translational correction of this manuscript.

Funding

There is no funding source.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was not required due to the retrospective study design of a radiological analysis.

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Copyright information

© SICOT aisbl 2017

Authors and Affiliations

  1. 1.OFZ InnsbruckInnsbruckAustria
  2. 2.Orthopaedic DepartmentMedical University of InnsbruckInnsbruckAustria

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