Akin Osteotomy: A Review of Modern Fixation Techniques

Akin osteotomy is commonly used to correct hallux valgus interphalangeus (HVI) deformity. The preferred implant for fixation remains an area of debate, often influenced by the surgeon's inclinations and expertise. This review compares the outcomes of contemporary fixation methods utilized in Akin osteotomy. PubMed served as the primary electronic database for the search. The interventions encompassed the use of screw(s), staple(s), and suture(s). The participants considered were adults aged 18 and above, undergoing Akin osteotomy either as a primary procedure or as an adjunct. Excluded were osteotomies performed via percutaneous or minimally invasive methods. Seven studies involving 590 feet were analysed, showcasing an impressive 99.8% overall union rate. The incidence of overall complications stood at 8.98%, with metal prominence notably higher in the screw fixation group (10.5%). All studies exhibited postoperative improvement in radiological angles. Screw, staple, and suture fixations demonstrated excellent union rates. While screws and staples offer robust osteotomy fixation, they pose risks of metal irritation and prominence. Suture fixation delivers comparable outcomes to the other two stabilization methods at a lower cost.