J Korean Foot Ankle Soc.  2024 Sep;28(3):114-118. 10.14193/jkfas.2024.28.3.114.

Minimally Invasive Distal Transverse Metatarsal Osteotomy – Akin Osteotomy (MITA) for Recurrent Hallux Valgus: A Report of Four Cases

• Kang T
• Lee D
• Yoo TW
• Seo SG

• KMID: 2559642
• DOI: http://doi.org/10.14193/jkfas.2024.28.3.114

Abstract

Recurrent deformity following hallux valgus surgery can be technically challenging to treat. In cases of revision surgery, a surgical technique with greater corrective power is often chosen compared to the primary surgery. Therefore, minimally invasive surgery is not commonly performed. On the other hand, minimally invasive surgery minimizes soft tissue damage and allows for greater correction of deformity compared to traditional open approaches. This paper reports four cases of recurrent hallux valgus treated with a minimally invasive distal transverse metatarsal osteotomy – Akin osteotomy (MITA), resulting in significant improvements in the clinical and radiographic outcomes.

Keyword

Forefoot; Recurrent hallux valgus; Minimally invasive surgery

Figure

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  Figure 1 Recurrent hallux valgus deformity, left foot. (A) Clinical photograph. (B) Weight-bearing anteroposterior foot radiograph.

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  Figure 2 Intraoperative fluoroscopy images. (A) Transverse extra-articular distal metatarsal osteotomy was performed with oscillating saw. (B) By inserting periosteal elevator to the medullary space distal fragment was translated to the lateral side. 1.6 mm guide pin inserted. (C) Repeat process for second screw. (D) Medial eminence was removed by using oscillating rasp. (E) Akin osteotomy. (F) Insertion of full-thread 3.0 mm screw.

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  Figure 3 SG (Sang Gyo) bunion rasp, oscillating instrument for medial eminence resection.

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  Figure 4 Weight-bearing anteroposterior foot radiographs taken. (A) Immediately posteoperative. (B) 3-month. (C) Following implant removal surgery demonstrating correction of recurrent hallux valgus deformity.

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  Figure 5 8-month postoperative correction following surgery. (A) Clinical photograph. (B) Weight-bearing anteroposterior foot radiograph.

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  Figure 6 Weight-bearing anteroposterior foot radiographs taken. (A) Preoperative. (B) 3-month. (C) 7 months following implant removal surgery demonstrating correction of recurrent hallux valgus deformity.

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  Figure 7 Weight-bearing anteroposterior foot radiographs taken. (A) Preoperative. (B) 4-month demonstrating correction of recurrent hallux valgus deformity.

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