Ferraz Ferreira Gabriel, Araujo Nunes Gustavo, Fiorin da Costa Gabriel, Mattos E Dinato Mauro Cesar, Lorchan Lewis Thomas, Ray Robbie, Alves Patriarcha Vitor, Carvalho Paulo, Viana Pereira Filho Miguel
Instituto Prevent Senior, São Paulo, Brazil.
ÓRION Orthopaedical Clinic, Brasília, Brazil.
Eur J Orthop Surg Traumatol. 2025 May 23;35(1):212. doi: 10.1007/s00590-025-04316-2.
Minimally invasive or percutaneous techniques for correcting hallux valgus (HV) have been increasingly prominent in scientific publications. However, the Akin osteotomy has received little attention. The aim of this study was to evaluate whether there is a difference between fixation or non-fixation of the Akin osteotomy for percutaneous HV correction.
Thirty-one patients (47 feet) were retrospectively identified, with a minimum 2-year follow-up, and divided into two cohorts: The first cohort comprised 16 patients (24 feet, 8 bilateral) who underwent using the Percutaneous Chevron and Akin (PECA) technique with Akin osteotomy fixation, while the second cohort included 15 patients (23 feet, 8 bilateral) without Akin fixation. Pre- and post-operative radiographic and clinical outcomes, including assessment of pain measured on the Visual Analog Scale, function evaluated using the American Orthopedic Foot and Ankle Society score, range of motion, and personal satisfaction, were conducted.
Both groups showed improvement in all parameters after the surgical procedure (p < 0.05), except for the reduced range of motion (p < 0.001). There was no difference between the groups in radiographic angles, function, personal satisfaction, range of motion, and complications (p > 0.05).
The non-fixation of the Akin osteotomy in the PECA technique for HV did not show clinical, radiographic, or complication differences when compared to Akin osteotomy fixation with a screw. Both groups demonstrated significant improvement in all parameters. However, a reduced range of motion (stiffness) was noted in the final evaluation.
Level III, retrospective comparative study.
用于矫正拇外翻（HV）的微创或经皮技术在科学出版物中越来越突出。然而，Akin截骨术却很少受到关注。本研究的目的是评估经皮矫正HV时Akin截骨术固定与不固定之间是否存在差异。
回顾性确定31例患者（47足），至少随访2年，并分为两个队列：第一个队列包括16例患者（24足，8例双侧），他们接受了使用经皮契形截骨术和Akin截骨术固定的经皮契形截骨术和Akin截骨术（PECA）技术，而第二个队列包括15例患者（23足，8例双侧），未进行Akin固定。进行了术前和术后的影像学和临床结果评估，包括用视觉模拟量表测量疼痛、用美国矫形足踝协会评分评估功能、活动范围和个人满意度。
手术操作后两组所有参数均有改善（p < 0.05），但活动范围减小除外（p < 0.001）。两组在影像学角度、功能、个人满意度、活动范围和并发症方面无差异（p > 0.05）。
与用螺钉固定Akin截骨术相比，在PECA技术中不固定Akin截骨术矫正HV在临床、影像学或并发症方面未显示出差异。两组在所有参数上均显示出显著改善。然而，在最终评估中注意到活动范围减小（僵硬）。
III级，回顾性比较研究。
