Clinical Deformity Correction Following Minimally Invasive Akin Osteotomy Fixated With a 2.5 mm Screw as an Adjunct to First Metatarsal Osteotomy: A Prospective Study

The medial closing wedge osteotomy of the proximal phalanx, known as the Akin osteotomy, is a commonly utilized procedure to help achieve hallux valgus (HV) deformity correction. With developments in surgical instrumentation, the option to perform osteotomies percutaneously has grown in popularity. We analyzed radiographic alignment of prospectively enrolled subjects that underwent percutaneous Akin osteotomy fixation with a single screw as an adjunct to first metatarsal osteotomy. Over 2 years, 86 Akin osteotomies were performed on 83 patients. Average follow-up was 68 (range: 43 to 151) weeks. IPA changed by median −5.0 (IQR: −7.5 to 0.5) degrees ( P <0.001). PDPAA changed by median −4.0 (IQR: −7.5 to 0.0) degrees ( P <0.001). Toe separation increased by median 5 (IQR: 3 to 7) mm ( P <0.001). There were no proximal phalangeal nonunions and incremental improvement in HV deformity correction was maintained. Patients who underwent minimally invasive Akin osteotomy with 2.5 mm cannulated fully-threaded screws improved in radiographic and clinical alignment. Complication rates were low, and incremental improvement in HV deformity correction was maintained. Level of Evidence:​​​​​​ Level III—nonrandomized prospective cohort study.