Revisiting the original Akin technique: A comparative analysis of radiographic outcome |
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| Institution: | 1. Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Germans Trias i Pujol, School of Medicine, Autonomous University of Barcelona, Carretera de Canyet, s/n, 08916 Badalona (Barcelona), Spain;2. Queen Mother Hospital for Small Animals, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire AL9 7TA, UK;3. Department of Psychiatry and Forensic Medicine, School of Medicine, Autonomous University of Barcelona, 08193 Bellaterra (Barcelona), Spain;1. Department of Orthopedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy;2. Department of Surgery, Orthopedic Unit, Bambino Gesù Children’s Hospital, Rome, Italy;1. Division of Orthopaedic Surgery, Jewish General Hospital, Montreal, QC, Canada;2. Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, QC, Canada;3. Faculty of Medicine, McGill University, Montreal, QC, Canada;1. Professor Pediatric Orthopedic Surgery, Palestine Polytechnic University, PO Box 3985, Ramallah, Palestine;2. Radiology Department, Annajah Medical School, Palestine;3. Radiology Department, Hamad Hospital, Qatar;4. Annajah Medical School, Palestine;1. Hospital Beatriz Ângelo, Portugal;2. Hospital da Luz Lisboa, Portugal;1. Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK;2. Orthopaedic Surgery, The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK;3. Trauma and Orthopaedic Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK;4. Dept of Trauma and Orthopaedic Surgery, Royal Surrey County Hospital NHS Trust, Guildford, UK;5. School of Physical Therapy, Faculty of Health Sciences, Western University, London, Canada |
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| Abstract: | BackgroundThe Akin osteotomy is widely used to correct the hallux valgus and different fixation techniques have been proposed. Currently most of these procedures coexist, with disagreement on which offers the best results. The aim of this study is to compare the radiological outcome of the original Akin’s technique with one in which a staple was used to stabilize the osteotomy. We also assessed whether other factors unrelated to the osteosynthesis could influence the radiological outcome.MethodsWe retrospectively reviewed data from 118 patients who underwent a scarf and Akin osteotomy. In 60 patients the Akin osteotomy was fixed with a staple and in 58 cases no staple was used. Hallux valgus angle (HVA), distal articular set angle (DASA), interphalangeal angle (IPA) and tibial sesamoid position were measured. The presence of lateral cortex disruption of the phalanx was also included in the analysis.ResultsSix variables significantly influenced the radiological results of the Akin osteotomy: preoperative HVA, IPA and tibial sesamoid position, laterality, postoperative cortical disruption and use of a staple.ConclusionOurs results suggest that the original Akin’s technique seems to offer equal or better results than a variation in which a staple is added to stabilize the osteotomy.Level of evidenceThis is a level III retrospective case-control study. |
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| Keywords: | Scarf osteotomy Akin osteotomy Hallux valgus Staple Distal articular set angle Hallux valgus angle Interphalangeal angle Tibial sesamoid position Lateral cortex disruption |
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