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Resection of the lateral sesamoid
67%
2164/3214
Lack of lateral capsular release
8%
260/3214
Lack of medial metatarsophalangeal joint capsule closure
256/3214
Use of an Akin procedure alone for a moderate to severe deformity
10%
316/3214
Undercorrection of the widened 1-2 intermetatarsal (IMA) angle
6%
206/3214
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The patient has bilateral hallux valgus. Resection of the lateral sesamoid would likely lead to hallux varus and not hallux valgus recurrence. Akin procedure is a closing wedge osteotomy of the proximal phalanx when the proximal phalangeal articular angle >10° but does not correct hallux valgus well. Metatarsal osteotomies, such as the Chevron, are used to bring the metatarsal shaft laterally to reduce the IMA but undercorrection of the IMA would likely lead to hallux valgus recurrence. Lateral soft tissue release and medial capsular reefing can be used to correct hallux valgus in combination with bony procedures, but its important to avoid an extensive lateral capsular release to minimize the risk of metatarsal head osteonecrosis.
3.4
(56)
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