Soft tissue fixation using sutures for the Akin osteotomy in forefoot pathology. Can we abandon fixation with...

To provide information regarding the safety and effectiveness of soft tissue suturing as a fixation method for the Akin osteotomy (AO).

We present a retrospective study involving 42 patients with hallux valgus who underwent a first metatarsal (MTT) procedure, all of whom additionally received an AO. The fixation method consisted of soft tissue suturing, supplemented with a cohesive bandage. We recorded the time to bone healing in all patients, as well as the length of the proximal phalanx of the hallux (P1) preoperatively, and at 1, 3, and 6 months postoperatively.

In our series, 100% of AO fixed using soft tissue suturing achieved bone consolidation within an average of 4.5 months (SD: 0.3). No statistically significant differences were found (p>0.5) between the P1 length measured at one month postoperatively (2.56mm; SD: 0.04) and at the final radiographic evaluation (2.57mm; SD: 0.04). Similarly, there were no significant differences between the postoperative distal articular set angle (DASA) (2.20; SD: 1.05) and the value at 6 months post-surgery (2.36; SD: 1.34).

Fixation of the AO using soft tissue suturing represents a simple, safe, reproducible, effective, and low-cost technique for maintaining the desired initial correction, while also avoiding complications associated with conventional osteosynthesis systems. To the best of our knowledge, this is the first reported series evaluating the efficacy of this type of fixation as a method of osteosynthesis for the AO.