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Minimally Invasive vs Open Akin Osteotomy.

Sebastian Schilde1, Karl-Stefan Delank1, Dariusch Arbab2

  • 1Department of Orthopaedics and Traumatology, Martin Luther University Halle Wittenberg, Halle, Germany.

Foot & Ankle International
|November 10, 2020
PubMed
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This summary is machine-generated.

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Minimally invasive Akin osteotomy with K-wire fixation effectively corrects the interphalangeal angle (IPA) without compromising bone healing, even with lateral cortex breaches. This technique offers comparable outcomes to open surgery.

Area of Science:

  • Orthopedic surgery
  • Foot and ankle surgery
  • Surgical techniques

Background:

  • Minimally invasive Akin osteotomy is gaining popularity due to potential benefits like faster recovery.
  • Preserving lateral cortex integrity during Akin osteotomy is challenging due to limited visual control.
  • This study compares minimally invasive and open Akin osteotomy outcomes.

Purpose of the Study:

  • To investigate clinical and radiographic outcomes of minimally invasive versus open Akin osteotomy.
  • To analyze the impact of lateral cortex violation on correction and bone healing.
  • To compare K-wire fixation in minimally invasive surgery with screw fixation in open surgery.

Main Methods:

  • Retrospective comparative study of 184 patients (210 feet) with hallux valgus and pathologic interphalangeal angle (IPA).
Keywords:
Akin osteotomybunionburrfracturehallux valgusminimally invasive surgery

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  • Minimally invasive Akin osteotomies (n=124) fixed with K-wires compared to open osteotomies (n=86) with screw fixation.
  • Radiographic and clinical assessment of IPA and bony consolidation at 1 day, 6 weeks, and 12 weeks postoperatively.

    • Main Results:

    • No significant difference in preoperative or postoperative IPA between minimally invasive (MI) and open surgery (OS) groups.
    • Lateral cortex breach occurred more frequently in MI (51.6%) than OS (13.9%), primarily due to burr use in MI.
    • Bony consolidation was achieved by 12 weeks in MI and 6 weeks in OS. Infections were unrelated to the osteotomy site.

    Conclusions:

    • Intraoperative breach of the lateral cortex does not negatively affect bone healing or IPA correction.
    • Minimally invasive Akin osteotomy with K-wire fixation yields results comparable to open surgery with screw fixation.
    • Both techniques are effective for correcting pathologic IPA in hallux valgus surgery.