Journal of Bone Research
Open Access

Chevron-Akin Osteotomy Surgical Technique for Hallux Valgus Correction

Wei Chiao Chang^{* *}Correspondence: Wei Chiao Chang, Department of Medical Genetics, Kaohsiung Medical University, Taiwan, Email:

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Description

Hallux valgus is a common foot deformity characterized by the deviation of the big toe towards the lesser toes, resulting in pain, discomfort, and aesthetic concerns for patients. While nonsurgical interventions such as footwear modifications and orthotics may provide temporary relief, severe cases often require surgical correction. Chevron-Akin osteotomy is a widely employed surgical technique for addressing hallux valgus, offering significant benefits in terms of realigning the toe, improving function, and reducing pain. This article explores the principles, procedure, and outcomes associated with Chevron- Akin osteotomy, shedding light on its efficacy as a treatment option for hallux valgus.

Understanding hallux valgus and indications for surgery

Hallux valgus is primarily caused by biomechanical factors, including abnormal foot structure, ligament laxity, and abnormal gait patterns. As the condition progresses, the metatarsal bone shifts laterally, resulting in the angulation of the big toe towards the smaller toes. In cases where conservative treatments fail to provide relief, surgical intervention becomes necessary.

Principles and procedure of Chevron-Akin osteotomy

The Chevron-Akin osteotomy is a combination of two procedures that address different aspects of hallux valgus deformity. The chevron osteotomy focuses on realigning the metatarsal bone, while the Akin osteotomy corrects the deviation of the phalanx bone. The procedure is typically performed under regional anesthesia, and various techniques, including open and minimally invasive approaches, can be utilized.

Chevron osteotomy: The chevron osteotomy involves making a V-shaped cut in the base of the metatarsal bone, enabling the surgeon to reposition it in a corrected alignment. The apex of the V-shaped cut is directed towards the intermetatarsal joint, allowing for controlled realignment of the bone. Fixation devices such as screws or staples are employed to stabilize the bone in its new position.

Akin osteotomy: The Akin osteotomy is performed on the phalanx bone, addressing the deviation of the big toe. A small wedge-shaped cut is made in the proximal phalanx bone, allowing for medial translation and correction of the angular deformity. Similar to the chevron osteotomy, fixation devices are utilized to maintain the corrected position of the bone.

Postoperative management and recovery

Following Chevron-Akin osteotomy, patients typically require a period of immobilization, often in the form of a protective boot or cast. Weight-bearing may be limited initially, gradually transitioning to full weight-bearing over time. Physical therapy and exercises to regain range of motion and strengthen the foot may also be prescribed. The recovery period can vary depending on the extent of the deformity, patient factors, and the specific surgical technique employed.

Outcomes and complications

Chevron-Akin osteotomy has demonstrated favorable outcomes in the correction of hallux valgus deformity. Studies have reported improvements in pain, functional outcomes, and patient satisfaction following surgery. The realignment achieved through this technique helps restore normal alignment of the big toe, leading to improved gait mechanics and reduced pressure on surrounding tissues.

As with any surgical procedure, Chevron-Akin osteotomy carries potential risks and complications. These may include infection, delayed bone healing, malunion or nonunion of bones, recurrence of deformity, stiffness, and nerve damage. However, with proper patient selection, meticulous surgical technique, and adherence to postoperative care protocols, the occurrence of these complications can be minimized.

Chevron-Akin osteotomy is a well-established surgical technique for the correction of hallux valgus deformity. By addressing both the metatarsal and phalanx bones, it offers comprehensive realignment, improved function, and reduced pain for patients.

With appropriate patient selection, proper surgical technique, and adherence to postoperative protocols, Chevron-Akin osteotomy can provide successful outcomes in the management of hallux valgus. However, individual patient factors and deformity characteristics should be carefully considered, and a thorough evaluation by a qualified orthopedic surgeon is essential to determine the suitability of this procedure for each case.