Minimally Invasive Chevron Akin: Locking The Metatarsal-Cuneiform Joint

Area of Science:

• Orthopedic surgery
• Foot and ankle reconstruction
• Minimally invasive surgical techniques

Background:

• Hallux valgus (HV) is often associated with first metatarsal-cuneiform joint (1MTCJ) hypermobility.
• The Minimally Invasive Chevron Akin (MICA) procedure offers a potential treatment for HV with 1MTCJ involvement.

Purpose of the Study:

• To perform a radiographic analysis of the MICA procedure.
• To evaluate the effect of MICA on the 1MTCJ in patients with moderate to severe hallux valgus.

Main Methods:

• Radiographic analysis of 50 feet (40 patients) undergoing MICA for moderate to severe HV.
• Measurements included hallux valgus angle (HVA), intermetatarsal angle (IMA), intermetatarsal angle of the proximal fragment (IAPF), and distal first-second metatarsal distance (Dist 1-2).
• Preoperative and postoperative parameters were compared; IAPF was compared with preoperative IMA.

Main Results:

• Significant improvement in HVA (32.5° to 7.3°) and IMA (14.2° to 4.2°).
• Increased IAPF (4.8°) and Dist 1-2 (4.0 mm) indicating enhanced transversal stability.
• No radiographic complications were observed.

Conclusions:

• MICA effectively corrects conventional radiographic parameters for moderate to severe hallux valgus.
• The MICA procedure increases the transversal stability of the 1MTCJ by fixing it medially.
• Radiographic evidence supports MICA as a viable option for hallux valgus with 1MTCJ instability.