Analysis of Factors Influencing Corrective Power of Akin’s Osteotomy in 2D Plain Radiographs: What to Consider to Obtain Good Correction in Hallux Valgus Surgery
Abstract
1. Introduction
2. Material and Methods
2.1. Statistical Report
2.2. Ethics Statement
3. Results
4. Discussion
Limitations
5. Conclusions
- The presented study provides an approximation of the corrective power of Akin’s osteotomy. This power depends on several factors including the width of the base, the inclination of the medial cortical, the height at which the osteotomy is performed and the width of the base of the subtraction wedge (Figure 5).
- The data suggest not performing the osteotomy within 10 mm of the joint line to avoid intra-articular extension.
- Greater angle correction is achieved if the cut is more diaphyseal versus metaphyseal and if the subtraction wedge inclination has a less acute versus more acute angle.
- The DASA and IPOA calculated on 2D plain radiographs would appear to be unreliable factors for planning purposes.
- Finally, the greater the width of the subtraction wedge, the greater the correction. It is important to consider all factors together, and this explains why different magnitudes of correction can be achieved, as observed in this study.
- Between 5.9 and 9.3 degrees with 2 mm base wedges.
- Between 9.0 and 14 degrees with 3 mm wedges.
- Between 12.1 and 18.4 degrees with 4 mm wedges, depending on the starting position of the osteotomy (metaphyseal or diaphyseal area) and the inclination of the medial cortical wall.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables (N = 186) | Mean | SD | Min | Max | |
---|---|---|---|---|---|
DASA, ° | 1.11 | 3.96 | −12.00 | 12.00 | Measured angles |
IPOA, ° | 8.66 | 5.00 | −4.00 | 25.00 | |
HOT, mm | 5.14 | 1.45 | 1.57 | 8.08 | Osteotomy Height |
H2OT, mm | 8.91 | 1.50 | 5.38 | 12.85 | |
Lbase, mm | 16.71 | 1.48 | 12.66 | 23.23 | Width of the base (c) |
LMetaf1, (c), mm | 18.75 | 1.45 | 15.13 | 23.91 | |
LMetaf2, (c), mm | 17.43 | 1.62 | 13.57 | 23.95 | |
LMetaf3, (c), mm | 15.22 | 1.69 | 11.59 | 21.43 | |
LMetaf4, (c), mm | 13.41 | 1.56 | 9.98 | 17.96 | |
LMetaf5, (c), mm | 12.27 | 1.43 | 8.99 | 15.96 | |
M2mm-L1, (d), ° | 71.54 | 9.68 | 49.98 | 94.06 | Cortical angle measured (relative to the joint line) using short side (shear width over cortical) and increasing from 2 to 3 and 4 mm (d) |
M3mm-L1, (d), ° | 69.46 | 7.65 | 48.29 | 87.57 | |
M4mm-L1, (d), ° | 67.38 | 6.89 | 44.28 | 87.06 | |
M2mm-L2, (d), ° | 65.36 | 8.16 | 40.95 | 91.07 | |
M3mm-L2, (d), ° | 66.31 | 7.50 | 43.26 | 90.92 | |
M4mm-L2, (d), ° | 67.26 | 7.67 | 45.57 | 90.76 | |
M2mm-L3, (d), ° | 71.41 | 8.68 | 51.83 | 92.94 | |
M3mm-L3, (d), ° | 72.93 | 8.20 | 56.25 | 95.53 | |
M4mm-L3, (d), ° | 74.45 | 8.08 | 57.65 | 98.11 | |
M2mm-L4, (d), ° | 78.66 | 7.98 | 56.89 | 105.57 | |
M3mm-L4, (d), ° | 80.07 | 7.56 | 63.35 | 103.69 | |
M4mm-L4, (d), ° | 81.47 | 7.37 | 64.08 | 101.81 | |
M2mm-L5, (d), ° | 84.40 | 7.26 | 67.36 | 102.18 | |
M3mm-L5, (d), ° | 85.49 | 6.90 | 69.82 | 102.66 | |
M4mm-L5, (d), ° | 86.59 | 6.82 | 70.68 | 103.74 | |
e2mm-L1, (e), ° | 5.92 | 0.53 | 4.40 | 7.38 | Akin’s correction angle (with respect to joint line and cortical tilt) (e) |
e3mm-L1, (e), ° | 8.99 | 0.77 | 6.82 | 11.29 | |
e4mm-L1, (e), ° | 12.09 | 1.02 | 9.38 | 15.30 | |
e2mm-L2, (e), ° | 6.24 | 0.71 | 4.12 | 8.47 | |
e3mm-L2, (e), ° | 9.61 | 1.05 | 6.70 | 12.73 | |
e4mm-L2, (e), ° | 13.06 | 1.38 | 9.60 | 16.86 | |
e2mm-L3, (e), ° | 7.41 | 0.93 | 5.07 | 9.94 | |
e3mm-L3, (e), ° | 11.31 | 1.31 | 7.99 | 14.85 | |
e4mm-L3, (e), ° | 15.24 | 1.65 | 10.76 | 19.49 | |
e2mm-L4, (e), ° | 8.59 | 1.01 | 5.93 | 11.55 | |
e3mm-L4, (e), ° | 12.95 | 1.44 | 9.20 | 17.28 | |
e4mm-L4, (e), ° | 17.20 | 1.82 | 12.60 | 22.73 | |
e2mm-L5, (e), ° | 9.40 | 1.05 | 7.06 | 12.84 | |
e3mm-L5, (e), ° | 14.01 | 1.50 | 10.77 | 19.02 | |
e4mm-L5, (e), ° | 18.42 | 1.90 | 14.12 | 24.49 |
Variables | Female | Male | p-Value |
---|---|---|---|
N = 166 | N = 20 | ||
DASA, ° | 1.00 [0.00;3.00] | 1.00 [1.00;3.25] | 0.272 |
IPOA, ° | 9.00 [6.00;12.0] | 6.50 [5.00;11.0] | 0.277 |
Lbase, mm | 16.4 [15.7;17.4] | 17.0 [16.8;17.7] | 0.002 |
LMetaf1 (c), mm | 18.4 [17.7;19.4] | 20.4 [18.9;21.9] | <0.001 |
LMetaf2 (c), mm | 17.2 [16.3;18.1] | 19.5 [17.7;20.7] | <0.001 |
LMetaf3 (c), mm | 15.0 [14.0;15.8] | 16.7 [15.3;19.1] | <0.001 |
LMetaf4 (c), mm | 13.2 [12.3;14.1] | 15.1 [13.7;16.9] | <0.001 |
LMetaf5 (c), mm | 12.1 [11.2;12.9] | 13.9 [12.5;15.2] | <0.001 |
DASA | IPOA | DASA | IPOA | ||
---|---|---|---|---|---|
IPOA | 0.458 *** | IPOA | 0.458 *** | ||
e2mm-L1 (e) | −0.123 | −0.011 | M2mm-L1 (d) | −0.016 | 0.036 |
e3mm-L1 (e) | −0.159 * | −0.028 | M3mm-L1 (d) | −0.112 | −0.031 |
e4mm-L1 (e) | −0.189 ** | −0.048 | M4mm-L1 (d) | −0.226 ** | −0.120 |
e2mm-L2 (e) | −0.252 *** | −0.197 ** | M2mm-L2 (d) | −0.326 *** | −0.262 *** |
e3mm-L2 (e) | −0.244 *** | −0.177 * | M3mm-L2 (d) | −0.426 *** | −0.302 *** |
e4mm-L2 (e) | −0.218 ** | −0.149 * | M4mm-L2 (d) | −0.487 *** | −0.312 *** |
e2mm-L3 (e) | −0.244 *** | −0.122 | M2mm-L3 (d) | −0.521 *** | −0.286 *** |
e3mm-L3 (e) | −0.195 ** | −0.102 | M3mm-L3 (d) | −0.563 *** | −0.305 *** |
e4mm-L3 (e) | −0.134 | −0.075 | M4mm-L3 (d) | −0.581 *** | −0.312 *** |
e2mm-L4 (e) | −0.176 * | −0.062 | M2mm-L4 (d) | −0.581 *** | −0.283 *** |
e3mm-L4 (e) | −0.115 | −0.034 | M3mm-L4 (d) | −0.596 *** | −0.293 *** |
e4mm-L4 (e) | −0.053 | −0.003 | M4mm-L4 (d) | −0.593 *** | −0.294 *** |
e2mm-L5 (e) | −0.145 * | −0.022 | M2mm-L5 (d) | −0.566 *** | −0.265 *** |
e3mm-L5 (e) | −0.083 | 0.006 | M3mm-L5 (d) | −0.588 *** | −0.272 *** |
e4mm-L5 (e) | −0.020 | 0.034 | M4mm-L5 (d) | −0.589 *** | −0.269 *** |
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Testa, E.A.; Ruiz Nasarre, A.; Alvarez Goenaga, F.; Poggio Cano, D.; Porreca, A.; Baduell, A.; Garcia Elvira, R.; Dalmau-Pastor, M.; Ruiz Riquelme, P. Analysis of Factors Influencing Corrective Power of Akin’s Osteotomy in 2D Plain Radiographs: What to Consider to Obtain Good Correction in Hallux Valgus Surgery. Diagnostics 2025, 15, 1618. https://doi.org/10.3390/diagnostics15131618
Testa EA, Ruiz Nasarre A, Alvarez Goenaga F, Poggio Cano D, Porreca A, Baduell A, Garcia Elvira R, Dalmau-Pastor M, Ruiz Riquelme P. Analysis of Factors Influencing Corrective Power of Akin’s Osteotomy in 2D Plain Radiographs: What to Consider to Obtain Good Correction in Hallux Valgus Surgery. Diagnostics. 2025; 15(13):1618. https://doi.org/10.3390/diagnostics15131618
Chicago/Turabian StyleTesta, Enrique Adrian, Alberto Ruiz Nasarre, Fernando Alvarez Goenaga, Daniel Poggio Cano, Annamaria Porreca, Albert Baduell, Ruben Garcia Elvira, Miki Dalmau-Pastor, and Pablo Ruiz Riquelme. 2025. "Analysis of Factors Influencing Corrective Power of Akin’s Osteotomy in 2D Plain Radiographs: What to Consider to Obtain Good Correction in Hallux Valgus Surgery" Diagnostics 15, no. 13: 1618. https://doi.org/10.3390/diagnostics15131618
APA StyleTesta, E. A., Ruiz Nasarre, A., Alvarez Goenaga, F., Poggio Cano, D., Porreca, A., Baduell, A., Garcia Elvira, R., Dalmau-Pastor, M., & Ruiz Riquelme, P. (2025). Analysis of Factors Influencing Corrective Power of Akin’s Osteotomy in 2D Plain Radiographs: What to Consider to Obtain Good Correction in Hallux Valgus Surgery. Diagnostics, 15(13), 1618. https://doi.org/10.3390/diagnostics15131618