Comparison of the Type of Fixation of Akin Osteotomy
Henryk Liszka1, Artur Gądek1,2
11 Department of Orthopedics and Rehabilitation, University Hospital in Krakow, Krakow, Poland.
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.
More Related Videos
10:09Adjustable Stiffness, External Fixator for the Rat Femur Osteotomy and Segmental Bone Defect Models
Published on: October 9, 2014
07:41An Intramedullary Locking Nail for Standardized Fixation of Femur Osteotomies to Analyze Normal and Defective Bone Healing in Mice
Published on: November 13, 2016
Related Concept Videos
02:57The Sense of Self: Reflected Self-Appraisal and Social Comparison
01:03Fixation and Sectioning
The simplest type of preparation is the wet mount, in which the specimen is placed in a drop of liquid on the slide. A liquid specimen can be directly deposited on the slide using a dropper. Solid specimens, such as skin scraping, can be placed on the slide before adding a drop of liquid to prepare the wet mount. Sometimes the liquid is simply water, but stains are often added...
01:28Carbon-dioxide Fixation
01:13Multiple Comparison Tests
It would be easy to compare two samples using a significance alpha level of 0.05. In other words, there is only one sample pair to be compared. However, it would be difficult to identify a significantly different sample if the number...
02:54Evolutionary Relationships through Genome Comparisons
01:24Comparison Between Electrical And Gravitational Forces
Since both are inverse square law forces, the distance gets canceled when the ratio of the two forces is considered. Instead, the ratio of the electrical and gravitational forces depends on...