• Arch Orthop Trauma Surg · Sep 2023

    Minimally invasive Chevron Akin (MICA) osteotomy for severe hallux valgus.

    • Gustavo Araujo Nunes, Kepler Alencar Mendes de Carvalho, Gabriel Ferraz Ferreira, FilhoMiguel Viana PereiraMVP0000-0002-2320-9769Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil.Instituto Vita, São Paulo, Brazil., Andre Donato Baptista, Roberto Zambelli, and Jordi Vega.
    • MIFAS by GRECMIP: Minimally Invasive Foot and Ankle Society, Merignac, France. gustavoanunes@hotmail.com.
    • Arch Orthop Trauma Surg. 2023 Sep 1; 143 (9): 550755145507-5514.

    IntroductionThe minimally invasive Chevron Akin (MICA) osteotomy has been widely used to treat hallux valgus (HV). The purpose of this study was to present a case series of patients with severe HV undergoing surgical treatment using the MICA procedure and to evaluate the clinical and radiographic outcomes.Materials And MethodsRetrospective study including 60 consecutive feet (52 patients) undergoing MICA for severe HV. The data were collected pre- and post-operatively at the last follow-up. Patients were clinically evaluated by the visual analog pain scale (VAS) and AOFAS hallux MTP-IP score. Radiographic assessments included measurements of hallux valgus angle (HVA), intermetatarsal angle (IMA), metatarsal (MT) length, distal metatarsal articular angle (DMAA), and plantar translation of MT head. The complications were recorded during the follow-up.ResultsThe mean age was 59.9 years, and the mean follow-up was 20.5 months. The average AOFAS increased from 41.2 to 90.9 points, and the VAS from 8.1 to 1.3 at the last follow-up. The average HVA decreased from 41.2º to 11.6º, the IMA from 17.1º to 6.9º, and the DMAA from 17.9º to 7.8º. The average shortening of the first metatarsal and the plantar translation of the MT head was 5.1 mm and 2.8 mm, respectively. The most observed complication was hardware discomfort, observed in 5 feet (8.3%). There were two cases of recurrence (3.3%).ConclusionMICA technique was demonstrated in this series of cases to be an effective procedure for severe HV, with a low rate of recurrence and an acceptable rate of complications.Level Of EvidenceIV; case series.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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