Suture fixation of an Akin osteotomy: A cost effective and clinically reliable technique

Background: The Akin osteotomy is commonly performed as an adjunct to osteotomies of the first metatarsal for the correction of hallux valgus such as the scarf or chevron osteotomies. The Akin osteotomy is indicated for the correction of a hallux valgus interphalangeus and can be used supplementary in any first metatarsal osteotomy for a hallux valgus. Various techniques have been described for fixation of the osteotomy. Most commonly the osteotomy is held and fixed with metalwork consisting of either a staple [2,3], a screw [4,5] or wiring [6,7]. While these techniques have been shown to be effective they are not without complications. They may require the use of additional instrumentation and in particular there is a described incidence of subsequent implant removal due to irritation of surrounding tissues and migration of the implanted metalwork [8-12]. Suture fixation of osteotomies in the foot has previously been described [14,15]. This offers a cost effective method with reliable results without the risk of implant complication.

Method: In this study we report the outcomes of a large series performed by a single surgeon and compare them to a similar series of Akin osteotomies performed by a different surgeon at the same institute using the staple technique.

Results: The results demonstrate no significant difference in outcome between the two series and a significant cost saving with the use of the suture fixation.

Conclusions: As a result of the study, we advocate the use of suture fixation of Akin osteotomy as a cost effective and reliable alternative to other forms of fixation.