Austin/chevron osteotomy fixed with bioabsorbable poly-L-lactic acid single screw

The authors propose a new bioabsorbable fixation device to be applied to V-shaped transverse osteotomies of the head of the first metatarsal (Austin-chevron osteotomies) for hallux valgus surgery. Namely, a 3.3-mm. diameter cortical screw made of poly-L-lactic acid. This screw was applied in 30 patients with an average age of 44 years (range: 20 to 61). A total of 35 osteotomies was performed. The study refers to the period between 1992 and 1994 with a mean follow-up of 18 months (range: 12 to 36 months). The results of the study demonstrate good stability of the synthesis, with normal union (mean: 4 weeks), no adverse tissue reactions or osteolytic phenomena were noted. One patient developed avascular necrosis of the metatarsal head, which in the opinion of the authors, was not due to the device implanted. Over 90% of the patients were satisfied with both the aesthetic and functional results. The authors conclude that the poly-L-lactic acid cortical screw is a promising bioabsorbable fixation device for this corrective osteotomy in selected patients less than 50 years old, with good first metatarsal bone stock.