A medial closing wedge is removed, leaving the lateral cortex intact for stability
The wedge is closed to correct the deformity and stabilised with a staple, screw or wire
The Akin procedure is a medial closing wedge osteotomy used to correct hallux valgus interphalangeus. The fragments may be stabilised with a suture, wire or staple.
The Akin is not commonly done on its own; it is usually performed as a component of a larger procedure, in which a technique such as a chevron or scarf osteotomy is simultaneously used for the correction of MTP joint angulation and metatarsus primus varus. Two series of isolated Akin procedures both reported a high failure rate in the presence of significant uncorrected metatarsus primus varus.
The addition of an Akin osteotomy to a standard bunion procedure has become popular in the last ten years. Although it is intuituvely obvious to do this, there is no evidence that it actually improves clinical outcome