Outcomes and Complications for Minimally Invasive Distal Transverse Metatarsal Osteotomy-Akin Osteotomy (MITA) for...

Hallux valgus is one of the most common forefoot deformity, leading to impaired mobility and reduced quality of life. Minimally invasive surgical techniques offer potential advantages, including reduced soft tissue disruption and accelerated postoperative recovery. The present study aimed to assess the clinical and radiographic outcomes of Minimally Invasive Distal Transverse Metatarsal Osteotomy combined with Akin Osteotomy (MITA) in a large patient cohort.

A retrospective review was performed on 493 feet treated with MITA between March 2020 and December 2021 at a single orthopedic center. Radiographic parameters-including hallux valgus angle (HVA), intermetatarsal angle (IMA), sesamoid position, and foot width-were evaluated preoperatively and at multiple postoperative points up to one year. Clinical outcomes were assessed by the Visual Analog Scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) score, and the Manchester-Oxford Foot Questionnaire (MOXFQ), including each domain. Complications were classified into three grades according to severity. Statistical analysis included paired t-tests and repeated measures using a general linear model.

Significant improvements were demonstrated across all radiographic and clinical parameters. Mean HVA decreased from 34.24° to 8.38°, and IMA from 12.67° to 5.78° (p < 0.001). Cases with grade 3 sesamoid displacement decreased markedly, from 424 to 5. Clinical outcomes also improved substantially: VAS scores declined from 2.91 to 0.20, AOFAS scores increased from 82.20 to 99.11, and MOXFQ scores decreased from 36.02 to 4.39 (all p < 0.001). The majority of complications were minor (Grade 1), with transient neurapraxia being the most frequent (6.0%). Severe complications (Grade 3) were uncommon and manageable.

MITA provides effective correction of hallux valgus, achieving excellent radiographic alignment and favorable clinical outcomes. Its minimally invasive approach facilitates rapid postoperative recovery and is associated with a low complication profile, supporting its role as a viable alternative to conventional open procedures and previous generation MIS techniques.

This study was approved by the Korea National Institute for Bioethics Policy (KoNIBP) (Approval No. P01-202506-01-028). As participant data were anonymized, the study was retrospectively registered.