title: Analysis of the proximal phalanx size as a guide for an Akin closing wedge osteotomy.
abstract: BACKGROUND
  The Akin closing wedge osteotomy for correction of hallux valgus interphalangeus has experienced a resurgence in popularity. Commonly, the size of the osteotomy is visually judged intraoperatively. We present a means of performing the osteotomy more objectively.
  
  
  METHODS
  Radiographs of 101 feet were studied to derive mean values for dimensions of the hallux proximal phalanx in the general population. Based on these we calculated the size of osteotomy required for given corrections.
  
  
  RESULTS
  The mean hallux width 5 mm distal to the apex of the articular surface differed between males and females. In males the mean width was 18 mm (95% CI 17.5 to 18.8) and in females 15 mm (95% CI 14.5 to 15.5). For a 10 degree correction, an osteotomy with a 3 mm base would be required.
  
  
  CONCLUSIONS
  Although the Akin osteotomy dimensions are commonly estimated, a more objective method of planning the osteotomy is presented. The method can also be applied to any closing wedge osteotomy.
  
  
  CONCLUSIONS
  We believe this method of the Akin osteotomy can improve the accuracy of the surgery.
authors: Trauma and Orthopaedics Department, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK. oshannak@hotmail.com
authors: Odei
authors: O
authors: Shannak
authors: Khosrow
authors: K
authors: Sehat
authors: Sunil
authors: S
authors: Dhar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005545:Forefoot, Human / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006214:Hallux / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011859:Radiography