01/21/2025    Walter W. Strash, DPM

Celebrating 100 Years of the Akin Osteotomy:

The Akin osteotomy was first introduced by Dr.
Akin in 1925 as a straightforward yet effective
procedure to correct hallux valgus deformities.
This technique involves removing a wedge of bone
from the big toe to achieve better alignment.
Initially, the procedure did not attract much
attention, as other intra-articular procedures,
like the Keller osteotomy, were more commonly
utilized.

However, in 1967, Colloff and Weitz highlighted
the advantages of the Akin procedure, particularly
its effectiveness in correcting mild to moderate
deformities without causing disruption to the
joint. This renewed interest led to further
refinements of the procedure, including
adjustments for correcting both proximal and
distal angles of the phalanx, shortening long
toes, and addressing valgus rotation.

Today, the Akin osteotomy is widely used, often in
conjunction with other bunion correction
procedures. Techniques for incision, osteotomy
placement, and fixation have evolved over the
years, incorporating options such as monofilament
wires, K-wires, staples, and bone screws.
Preserving the lateral hinge during the procedure
is crucial for ensuring stability and promoting
healing. Various approaches are available to
optimize results and reduce complications.

**Preoperative Considerations:**
1. Distal Articular Set Angle (DASA)
2. Interphalangeal Joint Oblique Angle (IPOA)
3. Hallux Valgus Angle (HVA)
4. Intermetatarsal Angle (IMA)
5. Interphalangeal Angle (IPA)

**Benefits of the Akin Osteotomy:**
1. Improved hallux valgus correction when combined
with the Chevron osteotomy.
2. The combination of Chevron and Akin osteotomies
reduces the risk of increased HVA and IPA in long-
term follow-ups, leading to less recurrence due to
improved biomechanical positioning of the Extensor
Hallucis Longus (EHL) and Flexor Hallucis Longus
(FHL).
3. Adding the Akin osteotomy does not increase the
risk of adjacent-joint arthritis.
4. The procedure can be performed either through
an open approach or using minimally invasive
surgery (MIS).

Walter W. Strash, DPM, San Antonio, TX

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