An Akin osteotomy is a medial closing wedge osteotomy of the proximal phalanx of the great toe. It is used to correct hallux valgus interphalangeus. The Akin osteotomy is usually a component of a primary procedure in which a hallux valgus deformity is corrected. The osteotomy site is fixed with a DynaNite™ Nitinol staple, low-profile QuickFix™ cannulated screw, QuickFix Staples, or Plaple® fixation system.
A chevron osteotomy is the most common technique used to correct mild to moderate bunion deformities. Traditionally, this procedure has been performed through an open approach. However, since the advent of minimally invasive surgery (MIS), surgeons now have the option to perform a chevron osteotomy through small percutaneous incisions. Following the osteotomy, the capital fragment is shifted laterally and fixated with either Compression FT screws for the MIS approach or Compression PT screws for the traditional open approach.
Compression FT Screws Technique
The titanium Compression FT (fully threaded) screws come in 2.5 mm Micro, 3.5 mm Mini, 4.0 mm Standard, 5.0 mm Large, and 7.0 mm XL. The variable-stepped thread pitch and headless design helps reduce the risk of profile complications, provides compression, and allows for simplified insertion. Surgeons can now achieve zero-profile, stable fixation. The Compression FT family of screws now offers 5 diameters and 91 screw lengths to fit various orthopedic applications throughout the body.
Lapidus Hallux Valgus Correction
The Lapidus procedure is an arthrodesis of the first metatarsocuneiform joint. It is performed most commonly as a method to reduce the intermetatarsal angle (IMA) in the setting of hypermobility or arthritis of the first metatarsocuneiform joint.
Mini TightRope® Technique for Hallux Valgus
The Mini TightRope® procedure is useful as an alternative or adjunct method for reduction of the intermetatarsal angle. A FiberWire® and button construct is placed across (distally or proximally) the first and second metatarsals. Reduction of the IMA is obtained with a clamp. The Mini TightRope is tightened and tied. The reduced intermetatarsal angle is held at the desired degree of correction. Used alone or in conjunction another procedure, this technique affords a greater degree of strength and security than can be achieved with the soft tissue repair alone. Additionally, the Mini TightRope System provides a more technically straightforward method of maintaining the intermetatarsal angle than with conventional osteotomies while avoiding the complications associated with osteotomies. A buttress plate is available to be placed against the second metatarsal to spread the load of the Mini TightRopes more evenly.
Minimally Invasive Surgery
The Arthrex MIS product portfolio continues to grow with the introduction of the Minimally Invasive Bunionectomy System. This trajectory system helps achieve correction and fixation placement using a percutaneous approach. Designed to work with this specific system, the beveled fully threaded screws are angled to provide zero-profile fixation. Additionally, a dedicated power unit and instrumentation are available. The MIS line is further supported by Medical Education courses focused on minimally invasive techniques.
Proximal 1st Metatarsal Osteototomy
Proximal metatarsal osteotomies work well to achieve reliable deformity correction in patients with a large 1st-2nd intermetatarsal angle. They may help minimize rotation, shortening, and elevation of the metatarsal. A number of osteotomy techniques have been described, including Ludloff, Mau, proximal crescentic, proximal chevron, scarf, opening wedge, and closing wedge, among others.