Analysis of the proximal phalanx size as a guide for an Akin closing wedge osteotomy.

Abstract

The Akin closing wedge osteotomy for correction of hallux valgus interphalangeus has experienced a resurgence in popularity. Commonly, the size of the osteotomy is visually judged intraoperatively. We present a means of performing the osteotomy more objectively. Radiographs of 101 feet were studied to derive mean values for dimensions of the hallux proximal phalanx in the general population. Based on these we calculated the size of osteotomy required for given corrections. The mean hallux width 5 mm distal to the apex of the articular surface differed between males and females. In males the mean width was 18 mm (95% CI 17.5 to 18.8) and in females 15 mm (95% CI 14.5 to 15.5). For a 10 degree correction, an osteotomy with a 3 mm base would be required. Although the Akin osteotomy dimensions are commonly estimated, a more objective method of planning the osteotomy is presented. The method can also be applied to any closing wedge osteotomy. We believe this method of the Akin osteotomy can improve the accuracy of the surgery.