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Additional Akin Proximal Phalanx Procedure Has a Limited Effect on the Outcome of Scarf Osteotomy for Hallux Valgus Surgery

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Background

One of the most common supplementary techniques for hallux valgus (HV) surgery is proximal phalanx correction proposed by Akin. This study aims to determine the influence of the Akin procedure on the outcome of scarf osteotomy for HV correction.

Methods

This prospective randomized study on 145 patients diagnosed with moderate to severe HV who underwent a scarf corrective osteotomy was carried out between 2011 and 2016. Patients were divided into two groups based on the additional Akin correction of the proximal phalanx. Postoperative follow-up was 2 years. The patients underwent an examination performed by two orthopedic surgeons twice—at the primary visit (qualification for the surgery and the study) and at the final follow-up. In between, the patients remained under the care of one of the physicians. Data collected included biometric records, radiographs (eg, hallux valgus angle [HVA]), intermetatarsal angle, American Orthopaedic Foot & Ankle Society Hallux Metatarsophalangeal Index, and visual analog scale score for pain and satisfaction.

Results

There was a significant difference in comparison of the HVA between the groups at the final follow-up. Other collected parameters were similar (American Orthopaedic Foot & Ankle Society Hallux Metatarsophalangeal Index, level of pain, and satisfaction). The complication rate was also similar between the groups. We observed comparable rates of reconsent to the treatment and foot appearance satisfaction in both groups.

Conclusions

Regardless of additional Akin correction, the outcome was comparable. Despite a significant difference in HVA score, pain and satisfaction level were similar. Based on our results, the Akin procedure may not provide substantial benefit as an adjunct to the scarf procedure.

Department of Orthopaedic and Trauma Surgery, Medical University of Lodz, Lodz, Poland.

Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland.

Department of Psychology, Medical University of Lodz, Lodz, Poland.

Corresponding author: Marcin Domzalski, MD, PhD, Medical University of Lodz, Zeromskiego 113, Lodz 90-419, Poland. (E-mail: marcindomzalski@yahoo.com)