Minimally invasive Chevron-Akin (MICA) osteotomies without Akin fixation in hallux valgus correction: a case series with 2-year follow-up

Eur J Orthop Surg Traumatol. 2024 Jul;34(5):2339-2345. doi: 10.1007/s00590-024-03924-8. Epub 2024 Apr 7.

Abstract

Purpose: The minimally invasive Chevron-Akin (MICA) is considered the third generation of minimally invasive hallux valgus (HV) surgery, and its original description included fixation of the Akin osteotomy with a screw. The aim of this study is to evaluate a series of patients undergoing HV correction using the MICA technique without screw fixation of the Akin osteotomy.

Methods: We retrospectively evaluated 58 consecutive patients who underwent surgical correction for HV between August 2018 and March 2020. A total of 69 feet were evaluated with a minimum follow-up of 2 years. Clinical outcomes such as pain (VAS), function (AOFAS), range of movement, criteria personal satisfaction and complications were evaluated.

Results: The AOFAS score (mean ± standard deviation) significantly improved from 57.0 ± 8.6 preoperatively to 93.9 ± 8.7 postoperatively (p < .001) with a minimum follow-up of 2 years. The VAS score improved from 6.0 ± 1.8 preoperatively to 0.6 ± 1.4 at 2-year follow-up (p < .001), and the hallux valgus angle reduced from 39.7 ± 6.9 to 8.9 ± 9.0 (p < .001). The majority of patients (95.6%) reported the result as excellent or good, and the most common complication was the need to remove the screw (7.2%).

Conclusions: The use of MICA without Akin osteotomy fixation resulted in successful correction of hallux valgus with improvements in clinical and radiographic parameters.

Level of evidence: IV, case series.

Keywords: Akin osteotomy; Forefoot surgery; Hallux valgus; MICA; Percutaneous surgery.

MeSH terms

  • Adult
  • Aged
  • Bone Screws
  • Female
  • Follow-Up Studies
  • Hallux Valgus* / diagnostic imaging
  • Hallux Valgus* / surgery
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures* / methods
  • Osteotomy* / methods
  • Patient Satisfaction
  • Range of Motion, Articular
  • Retrospective Studies
  • Treatment Outcome