Akin osteotomy without internal fixation combined with modified Bösch osteotomy for the treatment of moderate to severe hallux valgus

Abstract Purpose: Clinical efficacy of Akin osteotomy without internal fixation combined with modified Bösch osteotomy in treating moderate to severe hallux valgus deformity. Methods: Of the 94 patients who underwent bunion orthopedic surgery from September 2022 to January 2024 at our institution, 48 patients with moderate to severe hallux valgus underwent an Akin osteotomy without internal fixation combined with modified Bösch osteotomy. Clinical efficacy was assessed using the American Orthopedic Foot and Ankle Society’s Forefoot scale, Hallux valgus angle (HVA), Intermetatarsal angle (IMA), and Distal metatarsal articular angle (DMAA). Results: According to the relevant criteria, 42 of 48 patients were included in this study. All patients were followed for a mean of 23 (range 18–30) months. At last follow-up the AOFS Forefoot scale was 87.4±12.0, the HVA was 15.0±1.8°, the IMA was 9.5±1.7°, the DMAA was 6.9±1.5°, all of which showed statistical differences compared to preoperative values（P< 0.0001）. The satisfaction rate was 93% in the total sample. There were no incision infections, no sensory paresthesia’s due to injury to the medial dorsal cutaneous nerve of foot, and no recurrences. Conclusion: Akin osteotomy without internal fixation combined with modified Bösch osteotomy for the treatment of moderate to severe hallux valgus provides satisfactory results, with small incisional scars, low risk of wound infection and nerve injury, stable internal fixation, and short rehabilitation time. Level of Evidence: Level IV, retrospective case series.