J Korean Foot Ankle Soc.  2017 Mar;21(1):1-6. 10.14193/jkfas.2017.21.1.1.

The Results of Medial Horizontal Suture Fixation of Akin Osteotomy in Hallux Valgus

• Yune YP
• Kim JH

• KMID: 2371966
• DOI: http://doi.org/10.14193/jkfas.2017.21.1.1

Abstract

PURPOSE
The purpose of this study was to analyze the clinical results of medial horizontal suture fixation of Akin osteotomy in hallux valgus and present its advantages.
MATERIALS AND METHODS
This study was based on 48 cases of 35 patients with Akin osteotomy, who underwent surgery of hallux valgus between December 2014 and July 2015, and with at least 12 months of follow-up. The mean age of patients was 46.9 years (range, 16~71 years). The mean follow-up duration was 15.9 months (range, 12~18 months). Clinical evaluations included pain visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS hallux metatarsophalangeal interphalangeal scale) score, and satisfaction score. Weightbearing anteroposterior radiographs were taken to measure the distal articular set angle (DASA) of the hallux. Radiographic bone union at 6 months follow-up was regarded as a success, while a loss of reduction and nonunion was regarded as a failure.
RESULTS
The mean pre- and postoperative pain VAS scores were 4.27 and 1.67, respectively (p<0.05). The mean AOFAS score improved from 59.7 to 80.5 (p<0.05). The DASA was improved from 8.15 to -2.57 (p<0.05). There was no case of skin irritation, cortical breakage, inflammation from the knot, and infection. All patients showed union without fixation failure.
CONCLUSION
The clinical and radiological evaluations in this study demonstrate reliable results without complication. The medial horizontal suture fixation of the Akin osteotomy was effective, and the advantage of this procedure was unnecessity of the material removal, preservation of the joint, and no skin irritation.

Keyword

Hallux valgus; Akin osteotomy; Suture fixation

MeSH Terms

Ankle
Follow-Up Studies
Foot
Hallux Valgus*
Hallux*
Humans
Inflammation
Joints
Osteotomy*
Pain, Postoperative
Skin
Sutures*
Weight-Bearing

Figure

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  Figure 1 Distal articular set angle.

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  Figure 2 Osteotomy is performed on the proximal phalanx 5 to 6 mm distal to the first metatarsophalangeal joint. The size of medial closing wedge osteotomy was determined by remaining valgus angle. (A) Anterior view. (B) Lateral view.

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  Figure 3 Two holes are placed horizontally on either side of osteotomy using 1.6 mm Kirschner wire. (A) Anterior view. (B) Lateral view.

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  Figure 4 No. 2 Ethibond sutures (Ethicon, USA) on straight needle are passed into both side holes. (A) Anterior view. (B) Lateral view.

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  Figure 5 Osteotomy site was closed and tied with Ethibond suture (Ethicon, USA). (A) Anterior view. (B) Lateral view.

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  Figure 6 (A) Preoperative weightbearing anteroposterior radiograph of 47-year-old woman shows hallux valgus in the left foot. (B) Radiograph at postoperative 18 months shows bone union.

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