Correlation of Loss of Correction With Postoperative Radiological Factors After Distal Chevron Osteotomy in Dependence of Concomitant Akin Osteotomy

Kaufmann, Gerhard; Braito, Matthias; Hofer, Philipp; Putzer, David; Ulmer, Hanno; Dammerer, Dietmar

doi:10.1053/j.jfas.2021.11.017

Cited by 6 publications

(6 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On reviewing prior research, findings have shown that combining chevron metatarsal osteotomy with Akin osteotomy leads to significantly improved correction and better maintenance of the corrected hallux valgus angle, compared to performing chevron metatarsal osteotomy in isolation. 13,14,17,19,23 Consequently, preventing the recurrence of hallux valgus is paramount in averting the worsening of second toe valgus. Furthermore, if the correction of hallux valgus is effectively sustained, especially with the incorporation of Akin osteotomy 4,5 —a medial closing-wedge osteotomy that includes the removal of the medial condylar prominence on the proximal phalanx—this approach may facilitate the potential correction of second toe valgus.…”

Section: Discussionmentioning

confidence: 99%

Improvement of Valgus Deviation of the Lesser Toes of Moderate to Severe Hallux Valgus After Proximal Chevron Metatarsal Osteotomy and Akin Osteotomy

Kang,

Lim,

et al. 2024

Foot Ankle Int.

View full text Add to dashboard Cite

Background: This study examines the correction of lesser toe valgus deviation following proximal chevron metatarsal osteotomy (PCMO) and Akin osteotomy in moderate to severe hallux valgus patients, while identifying influencing factors. Method: Among 89 patients (116 feet), those with moderate to severe hallux valgus underwent PCMO and Akin osteotomy. Radiologic assessments included preoperative metatarsus adductus angle (MAA), hallux valgus angle (HVA), intermetatarsal angle (IMA), valgus angles of the second to fourth metatarsophalangeal joints, and hallux valgus recurrence. Assessments included visual analog scale (VAS) pain scores, American Orthopaedic Foot & Ankle Society (AOFAS) scores, and patient satisfaction over an average follow-up of 30.6 ± 21.2 (range, 12-99) months. Results: The mean preoperative HVA of 34.4 degrees decreased to 8.7 degrees at final follow-up. The valgus angles of the second, third, and fourth toes improved by 37.1%, 27%, and 44.5%, respectively. In metatarsus adductus patients, lesser toe valgus angles were significantly higher both preoperatively and at final follow-up. Hallux valgus recurrence patients had higher preoperative and final follow-up IMA and valgus angles in the second and third toes. Nonrecurrence patients showed greater decreases in these angles. A larger HVA correction corresponded to a greater decrease in lesser toe valgus deviation. VAS and AOFAS scores improved significantly at the last follow-up. Conclusion: The study found a significant reduction in the valgus angle of the second, third, and fourth toes after PCMO and Akin osteotomy in moderate to severe hallux valgus cases, without additional surgeries on lesser toes. The lesser toe angular reductions were less pronounced in patients with metatarsus adductus or with hallux valgus recurrence. Level of Evidence: Level IV, case series.

show abstract

Section: Discussionmentioning

confidence: 99%

Improvement of Valgus Deviation of the Lesser Toes of Moderate to Severe Hallux Valgus After Proximal Chevron Metatarsal Osteotomy and Akin Osteotomy

Kang,

Lim,

et al. 2024

Foot Ankle Int.

View full text Add to dashboard Cite

show abstract

“…However, the loss of HVA or IMA correction after 3 months is known to be minor. 5,6 In this study, a group of patients with a follow-up period longer than 6 months, which is twice as long as this, was included; hence, it will not significantly affect the results. And among the factors known to be associated with the recurrence of hallux valgus, only limited representative factors known were included, but not all factors were included.…”

Section: Discussionmentioning

confidence: 99%

Long Hallucal Tendon Force Vectors and First Metatarsophalangeal Deformity After Hallux Valgus Surgery

et al. 2023

View full text Add to dashboard Cite

Background: Recurrence is one of the most common complications following hallux valgus surgery. Moreover, hallux varus occurs in cases of overcorrection. We aimed to quantitatively measure, using radiographic examination, the dynamics of the soft tissues that act on deformities (recurrence of valgus and occurrence of varus) after the surgery. Methods: This retrospective single-institution study included 60 patients (98 feet) who underwent hallux valgus surgery between 2009 and 2018. According to radiographic findings of the foot under weightbearing conditions at postoperative month 1, we examined the tendons’ pathway and calculated the forces on the first metatarsophalangeal joint, which we termed the deformity force angle (DFA). We compared whether there was a significant difference in DFAs between the groups in which deformities occurred and those in which deformities did not occur after correction. In addition, the DFA was compared to known radiographic measurements of hallux valgus recurrence (hallux valgus angle, distal metatarsal articular angle, intermetatarsal angle, and sesamoid position) to assess association with recurrence. Results: We observed a significant difference in the DFA between patients with and without hallux valgus recurrence ( P < .001) and between those with and without hallux varus ( P < .001) based on standing radiographs taken at a minimum of 6 months postoperation. For predicting the deformities, the areas under the curve were 0.863 (hallux valgus recurrence) and 0.831 (hallux varus occurrence), respectively, which was greater than other factors evaluated. The DFA values greater than 9.5 degrees and less than 5.5 degrees were associated with the recurrence of valgus and occurrence of varus, respectively. Conclusion: In our study, DFA was associated with hallux valgus recurrence when it exceeded 9.5 degrees and hallux varus when it was less than 5.5 degrees. Moreover, in the hallux valgus surgery we performed, a DFA from 5.5 to 9.5 degrees appeared to be a “safe zone” for preventing early deformity after surgery. Level of Evidence: Level III, prognostic.

show abstract

“…Apart from the first metatarsal osteotomy and soft-tissue procedures, the treatment is often combined with an osteotomy of the first proximal phalanx, such as Akin osteotomy. The objective of Akin osteotomy-a medial closing-wedge osteotomy-is to preserve the lateral cortex of the proximal phalanx during axis correction [20][21][22].…”

Section: Introductionmentioning

confidence: 99%

“…The use of combined chevron and Akin osteotomy has not been fully explored. There have been only three studies comparing selected radiographic parameters following a combined chevron-Akin osteotomy with those after chevron osteotomy alone [ 20 , 22 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes After Chevron Osteotomy with and Without Additional Akin Osteotomy: A Retrospective Comparative Study

Kuliński

Michal

Tomczyk

et al. 2023

JOIO

View full text Add to dashboard Cite

Background Chevron osteotomy is one of the most common approaches to hallux valgus corrective surgery. This procedure is often combined with Akin osteotomy of the proximal phalanx of the hallux. There are no definitive guidelines specifying the indications for a given osteotomy technique nor data on postoperative loss of correction or the effect of the type of first-ray surgery on the development of adjacent-joint arthritis. The aim of this study was to assess radiographic treatment outcomes via chevron osteotomy with and without Akin osteotomy. Methods The study evaluated 117 patients treated in the period 2016–2019. Ninety-nine of those patients underwent distal chevron osteotomy alone, and 18 patients underwent a combined chevron–Akin double osteotomy. The analyzed radiograms had been obtained preoperatively, at 6 weeks after surgery, and after a long-term follow-up. The following parameters were assessed: the intermetatarsal angle (IMA), hallux valgus angle (HVA), interphalangeal angle (IPA), postoperative recurrence of valgus deformity, adjacent-joint arthritis, and complications. Results Chevron-Akin osteotomy helped maintain lower HVA and IPA values in long-term follow-up in comparison with those in the patients who underwent chevron osteotomy alone. The chevron osteotomy group showed a significant increase in the mean HVA from 18.37° at the first follow-up visit to 20.81° at the last follow-up visit. There were no differences between the groups in terms of the remaining assessed radiographic parameters. Hallux valgus surgery does not increase adjacent-joint arthritis. Conclusion The use of combined chevron-Akin osteotomy does not affect HVA or IMA correction. The combination of chevron and Akin osteotomies reduces the risk of increased HVA and IPA in long-term follow-up. The additional Akin osteotomy does not increase the risk of adjacent-joint arthritis. Combining chevron osteotomy with Akin osteotomy is recommended in hallux valgus deformity correction.

show abstract

Correlation of Loss of Correction With Postoperative Radiological Factors After Distal Chevron Osteotomy in Dependence of Concomitant Akin Osteotomy

Cited by 6 publications

References 37 publications

Improvement of Valgus Deviation of the Lesser Toes of Moderate to Severe Hallux Valgus After Proximal Chevron Metatarsal Osteotomy and Akin Osteotomy

Improvement of Valgus Deviation of the Lesser Toes of Moderate to Severe Hallux Valgus After Proximal Chevron Metatarsal Osteotomy and Akin Osteotomy

Long Hallucal Tendon Force Vectors and First Metatarsophalangeal Deformity After Hallux Valgus Surgery

Outcomes After Chevron Osteotomy with and Without Additional Akin Osteotomy: A Retrospective Comparative Study

Contact Info

Product

Resources

About