+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Biomechanical comparison of internal fixation techniques for the Akin osteotomy of the proximal phalanx

Biomechanical comparison of internal fixation techniques for the Akin osteotomy of the proximal phalanx

Journal of Foot and Ankle Surgery 51(5): 561-565

The Akin osteotomy is performed at the proximal phalanx for correction of an abducted great toe in a hallux abducto valgus deformity. Several internal fixation techniques have been widely advocated; however, their respective stabilities have not been compared. A biomechanical analysis was performed comparing 5 commonly used fixation techniques for the Akin osteotomy to determine the strongest method in simulated weightbearing in sawbone models. An Akin osteotomy was uniformly performed on 25 sawbones and fixated with 5 different internal fixation types, including a 2-hole locking plate and locking screws, a heat-sensitive memory staple (8 mm × 8 mm), a 28-gauge monofilament wire, 2.7-mm bicortical screws, and crossed 0.062-in. Kirschner wires. The results of simulated weightbearing load to failure rates with an Instron compression device demonstrated the following mean load to failures: crossed Kirschner wire, 57.05 N; 2-hole locking plate, 36.49 N; monofilament wire, 35.69 N; heat-sensitive memory staple, 34.32 N; and 2.7-mm bicortical screw, 13.66 N. Statistical analysis demonstrated the crossed Kirschner wire technique performed significantly better than the other fixation techniques (p < .007); the 4 other techniques were found not to be significantly different statistically (p = .041) from each another. Our study results suggest a crossing Kirschner wire construct significantly increases the stability of the Akin osteotomy in a sawbone model. This might be clinically extrapolated in an effort to improve patient outcomes because these osteotomies can undergo nonunion and malunion, resulting in postoperative pain and swelling.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 051815464

Download citation: RISBibTeXText

PMID: 22819001

DOI: 10.1053/j.jfas.2012.05.001

Related references

Biomechanical Comparison of Internal Fixation Techniques for the Akin Osteotomy of the Proximal Phalanx. The Journal of Foot and Ankle Surgery 51(5), 2012

Akin osteotomy of the hallux proximal phalanx utilizing Richards mini staple fixation. Journal of Foot Surgery 26(2): 178, 1987

Hallux proximal phalanx Akin-Scarf osteotomy. Journal of the American Podiatric Medical Association 94(1): 70-72, 2004

Hallux proximal phalanx osteotomy The Akin procedure. Johnson, K A Master Techniques in Orthopaedic Surgery; The foot and ankle 65-72, 1994

Evaluation of Hallux Valgus Correction With Versus Without Akin Proximal Phalanx Osteotomy. Journal of Foot and Ankle Surgery 55(5): 910-914, 2016

Analysis of the proximal phalanx size as a guide for an Akin closing wedge osteotomy. Foot and Ankle International 32(4): 419-421, 2011

Correction of Hallux Valgus Interphalangeus With an Osteotomy of the Distal End of the Proximal Phalanx (Distal Akin Osteotomy). Foot and Ankle International 38(2): 153-158, 2017

Internal fixation of the akin osteotomy. Foot and Ankle International 16(3): 172-173, 1995

A biomechanical in vitro evaluation of different internal fixation techniques used in sagittal split ramus osteotomy for mandibular setback. International Journal of Oral and Maxillofacial Surgery 44: E306-E307, 2015

Biomechanical analysis of internal fixation techniques for proximal interphalangeal joint arthrodesis. Journal of Hand Surgery 11A(4): 562-566, 1986

Basicervical fractures of the proximal femur. A biomechanical study of 3 internal fixation techniques. Clinical Orthopaedics and Related Research 1994(306): 256-263, 1994

Comparison of Chevron-Akin osteotomy and distal soft tissue reconstruction-Akin osteotomy for correction of mild hallux valgus. Foot and Ankle Surgery 6(3): 155-163, 2000

Biomechanical Comparison Study of Three Fixation Methods for Proximal Chevron Osteotomy of the First Metatarsal in Hallux Valgus. Clinics in Orthopedic Surgery 9(4): 514-520, 2017

Osteotomy of the proximal phalanx with lag screw fixation. Journal of the American Podiatric Medical Association 78(1): 41-43, 1988

Staple fixation for akin proximal phalangeal osteotomy in the treatment of hallux valgus interphalangeus. Foot and Ankle International 36(4): 457-464, 2015