Paragraph Number

449

Following Lapidus surgery, surgeons and/or patients may feel that the distal portion of the big toe is not straight and normal looking. Therefore, surgeons may recommend an Akin osteotomy in which a medial to lateral closing wedge osteotomy is performed to straighten the toe (e.g., the proximal and distal phalanx). It is advantageous when performing an Akin osteotomy to not cut completely through to the far cortex of the bone, but instead to leave a portion of bone at the far cortex to allow the closing distal portion of bone to pivot around the resected wedge of bone. Should the remaining bone portion at the far cortex be too thick, then during closure, the bone bridge (e.g., remaining bone portion) could fracture resulting on the proximal phalanx becoming two separate pieces. Should the remaining bone portion at the far cortex be too thin, the two bone portions could break also resulting in two separate pieces. Having two separate pieces makes for greater challenges during fixation as the bone parts are now floating (free to move) relative to each other.

Added by DJM Jan 2024