Comparative Study of Akin Osteotomies with and Without Fixation in Open Hallux Valgus Correction Surgery: Retrospective Analysis of 200 Osteotomies

Background: In hallux valgus correction surgery, different fixation methods exist for Akin’s osteotomy, but no fixation is also a possibility. We hypothesized that Akin’s osteotomy, both fixed and non-fixed, would provide equally sufficient correction of the phalanx without differences in the measurements of the specific postoperative DASA and IPOA angles and no significant differences between the two groups in the rate of complications. Methods: A retrospective single-center comparative case–control study was conducted. Five radiological measurements were analyzed until completion of fusion. The incidence of complications occurring during and after surgery was assessed and compared across the study groups. Results: A total of 200 Akin osteotomies were evaluated; 100 were included in the group without fixation and 100 in the group with fixation. Radiologically, the results show that there is no difference in the corrective difference values in the main parameters between the groups. Regarding the analysis of complications, in the group without fixation, all cases achieved fusion. In the group with fixation, one case showed non-symptomatic non-union. Out of 200 operations, four (2%) patients required reoperation. A re-Akin osteotomy was needed for a hypocorrection in the group without fixation. One case in the fixed group went into asymptomatic non-union that did not require re-intervention. Conclusions: The absence of internal fixation does not seem to compromise the healing of the osteotomy, and the maintenance of correction grades and complication rates in the group without fixation seems to be similar to the group with fixation. The results are promising; however, we believe that further studies are needed to confirm the data.