Akin Osteotomy Surgery, Procedure, Recovery, CPT Code

What is Akin Osteotomy Surgery?

An akin osteotomy is a corrective surgical treatment that is performed on the big toe in order to rectify various abnormalities. The treatment involves repositioning and resecting the proximal phalanx (the bone nearest to the foot) of the big toe joint.

This surgery is often performed to address hallux valgus, also recognized as a bunion. Hallux valgus refers to an abnormal angle between the big toe and the second toe, which results in the formation of a bony hump at the base of the big toe. This may make it painful, uncomfortable, or challenging to wear certain shoes.

The goal of the surgery is to correct the alignment of the big toe as well as alleviate discomfort and deformity without affecting the rest of the foot. Internal fixation, such as bone screws or pins, is frequently employed during the procedure, which lasts about 30 minutes on average.

There are a few particular complications that come along with having this operation done, such as the possibility of over-correction (also known as hallux varus), non-union of bone (when the bones fail to fuse together), and fixation issues with screws and pins. However, it is a limited surgery that does not impact other joints and eliminates misalignment, the cause of the malformation.

An Akin osteotomy is a surgical procedure that can be used to treat hallux valgus interphalangeus. Individuals should consult with their physician to see if this surgery is appropriate for them.

Procedure

Hallux valgus interphalangeus, a displacement of the big toe towards the side, can be surgically corrected with an Akin osteotomy. The big toe is straightened during the surgery by making a tiny cut in the proximal phalanx (big toe base). The bone fragments are subsequently fixed with screws or staples. The Akin osteotomy is typically used to treat mild to moderate abnormalities and may be combined with additional procedures, such as a bunionectomy, or performed alone.

An Akin osteotomy can be done in a number of ways. One way involves stabilizing the bone pieces with a staple utilizing DynaNite Nitinol Staple, a minimally invasive technique. Another method, which OF Akin first proposed in 1925, is performing a medially positioned closing wedge osteotomy of the proximal phalanx.

The operation can be done in a single day with the patient under light general anesthesia and a regional nerve block. Patients may need to wear a cast or specialized shoe for weeks after surgery to keep their foot stable while it recovers. To assist the foot regain its strength and flexibility, physical treatment may also be advised.

Recovery

Depending on the patient and the complexity of the treatment, an Akin osteotomy's recovery period can differ. In most cases, the healing process can last a few weeks to a few months.

Pain, swelling, and discomfort in the operated foot are all potential side effects in the first few days after surgery. These symptoms can be managed with the aid of ice packs and painkillers. In order to help with edema reduction, patients must also keep their feet elevated.

To immobilize the foot and safeguard the surgery region, patients may need to wear a cast or specialized footwear. For a few weeks, they must refrain from putting any weight on the affected foot. To assist with mobility, the doctor can suggest using crutches or a wheelchair.

The patient may be given exercises by the therapist to perform at home to hasten the healing process. Patients should carefully adhere to their doctor's post-op care instructions for the best potential results. They must also keep all scheduled follow-up appointments to ensure a smooth recovery and deal with any issues that may emerge.

Akin Osteotomy Surgery CPT Code

Depending on the precise technique carried out, there may be different CPT codes for Akin osteotomy surgery. The CPT code 28299 is used to indicate the correction of hallux valgus (bunion) by double osteotomy, which involves the Austin-Akin method. But some sources recommend utilizing CPT code 28298 for a bunionectomy using phalanx osteotomy to treat the hallux. A second source recommends using CPT code 28310 for osteotomies including shortening, angular, or rotational realignment.