Анатомия и физиология: текущие исследования

Анатомия и физиология: текущие исследования
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ISSN: 2161-0940


Comparison between Transosseous Capsulorraphy and Akin Osteotomy in the Management of Hallux Valgus

Adnan A Faraj and Chad Chang

Introduction: Hallux valgus is a common forefoot deformity requiring surgical correction. It is most commonly corrected with first metatarsal osteotomy. Additional procedures may be necessary if there is inadequate correction of hallux valgus. Akin osteotomy was intended for correction of hallux valgus interphalangeus. However, it is now commonly considered as an additional procedure in hallux valgus correction. This study aims to evaluate radiological and clinical outcomes of patient undergoing Akin osteotomy and transosseous capsulorraphy.

Method: We evaluated 18 consecutive patients (23 feet) operated upon within a 4-month period. Retrospective analysis of preoperative and postoperative radiograph of 23 feet with first metatarsal osteotomy with either Akin osteotomy (n=10) or transosseous capsulorraphy (n=13) was performed. Several new radiological forefoot measurements were devised for this study. Complication and clinic outcomes were also recorded.

Results: Average hallux valgus angle correction from Akin osteotomy is 13.21° and for transosseous capsulorraphy is 15.11° (p=0.54). Mean hallux valgus interphalangeus angle increased in Akin group by 0.47° and for transosseous capsulorraphy 1.53° (p=0.49). There is no statistical difference between all preoperative radiological measurements between the Akin group and transosseous capsulorraphy group. There is statistical significance (p=0.02) between the two groups in changes to the first web space from their respective procedures. All patients were satisfied with the surgery with no complications recorded.

Conclusion: There is no significant advantage adding Akin osteotomy to first metatarsal osteotomy unless there is a pre-existing anomaly of the distal metatarsal articular angle (DMAA) and hallux valgus interphalangeus. Transosseous capsulorraphy is a safer alternative.