Surgical correction of severe hallux abducto-valgus deformity with minimally invasive chevron akin osteotomy: A systematic review

Abstract

Background

With the increasing use of minimally invasive surgical (MIS) techniques in the field of hallux abductovalgus (HAV) correction, foot and ankle surgeons are utilizing third-generation techniques, such as the minimally invasive chevron Akin (MICA) osteotomy, to repair bunions ranging in severity from mild to severe. Literature identifying the correction of severe HAV deformities with MIS techniques is sparse.

Purpose

A systematic review is presented of peer-reviewed sources to analyze complications, pre- and postoperative radiographic analysis, and patient-reported outcomes in correction of severe HAV deformity with the MICA surgical approach.

Study Design/Methods

After review of multiple databases, 4 articles were obtained matching our inclusion criteria, with 236 total feet.

Results

Complication rates ranged from 18.8 % to 24.2 %, while recurrence rates ranged from 3.8 % to 7.5 %. Average intermetatarsal angle improved from 17.81 degrees to 6.59 degrees, and hallux valgus angle improved from 42.18 degrees to 8.94 degrees. Improvements in the two radiographic angles were statistically significant. Improvement in patient-reported outcomes was appreciated among studies but unable to be analyzed statistically owing to low sample size and heterogeneity in reporting.

Conclusion

Thissystematic review revealed that the use of the MICA technique to correct severe HAV deformity showed significant improvement of radiographic angles, acceptable patient-reported outcomes, and complication and recurrence rates similar to those reporting on less severe deformity correction.

Level of Evidence

Level 4