A new suture fixation technique for the Akin Osteotomy of the Proximal Phalanx: You don’t need any implant

Various fixation methods have been described for Akin osteotomy, based on using metal implants or transosseous sutures. The aim of this study was to evaluate radiological outcomes and complications of closing wedge Akin osteotomy based on a crossed suture configuration of the joint capsule rather than using implants. The null hypothesis is that a crossed suture has comparable radiological results to other techniques, with no additional complications. It’s a retrospective study. Patients who underwent Akin osteotomy fixed either with implant or joint capsule suture between 2015 and 2018 were included. Distal articular set angle corrections in pre- and postoperative anteroposterior foot x-rays were calculated by 2 observers. Complications, such as pain, infection, non-union and need of surgery revision, was compared at 1 year follow-up. 89 patients, 30 in the implant group and 59 in the suture group. Mean distal articular set angle corrections were 6.43 (SD 5.54) and 7.36 (SD 5.48) degrees in the implant and suture groups, respectively, without statistically significant differences (p 0.454). Complications were 2 local pain and 1 wound infection cases in the suture and implant groups, respectively (p 0.138, p 0.197). Akin osteotomy with suture fixation yields comparable radiological results to metal implant fixation methods without increasing the associated complications. •This study evaluates and compares the radiological results between a new suture fixation for the Akin osteotomy.•This is a retrospective and descriptive study based on 89 patients that underwent a hallux valgus surgery.•No statistically significant differences were observed in the postoperative distal articular set angle between groups.•There was no evidence of non-union, excessive bone callus or loss of correction, nor were there major complications.