Conduit-assisted primary digital nerve repairs with 8-0 suture increases the maximum load to failure compared with repairs with 9-0 suture, as does increasing the overall number of sutures. Using 9-0 suture at the coaptation site with 8-0 suture at the nerve-conduit junction does not jeopardize tensile strength when compared with similar repairs using all 8-0 suture and may decrease inflammation at the repair site while still achieving sufficient tensile strength.

Hallux valgus is a very common orthopedic problem. In patients with pain not responsive to footwear and activity modification, chevron distal metatarsal osteotomy bunionectomy is a commonly performed and highly successful procedure for the treatment of mild and moderate hallux valgus. 3,4,6 We have previously reported our results in a prospective study of 57 patients who underwent chevron bunionectomy in which the metatarsal osteotomy was stabilized with an intramedullary plate system, 3 which secures the metatarsal shaft to the first metatarsal head after lateral displacement of the metatarsal head. The intramedullary device is secured to the head and shaft with 2.4-mm screws. Although our results with this technique were good, we wanted to evaluate the potential added benefit of performing an Akin osteotomy of the proximal phalanx in addition to the metatarsal osteotomy. This is the double osteotomy bunionectomy. When we first started performing this procedure, we observed that we were able to achieve a better cosmetic result with less aggressive tightening of the medial capsule and better range of motion of the first metatarsophalangeal (MTP) joint. Although most series of bunionectomies have good patient satisfaction, we wanted to see if the double osteotomy bunionectomy technique would result in a higher degree of patient satisfaction and better cosmesis. The purpose of this study was to prospectively evaluate the results of double osteotomy bunionectomy in a consecutive group of 138 patients operated on by a single surgeon over a 2-year period of time. Methods We performed double osteotomy bunionectomies on 138 consecutive patients (145 feet) between June 13, 2013, and March 18, 2015. All operative procedures were performed 800635F AIXXX10.

No abstract