Learning Curve of Third-generation Minimally Invasive Chevron-Akin Osteotomy for Hallux Valgus Correction in Asian Population: A Retrospective Cohort Study

Minimally invasive Chevron-Akin represents a paradigm shift from traditional open techniques in HV correction.The primary benefits of MICA include reduced soft tissue trauma due to smaller incisions, which can lead to faster recovery times, lower rates of wound complications, and better cosmetic outcomes.Furthermore, the percutaneous approach minimizes disruption to surrounding anatomical structures, potentially reducing postoperative pain and edema. 2 IntroductIon Hallux valgus (HV) is a common foot and ankle condition, seen in 2-4% of the population.Surgery is required in recalcitrant cases despite conservative measures, including a trial of footwear modification.1 Currently, there are minimally invasive methods that are utilized to correct deformities through fewer incisions, resulting in reduced surgical and postoperative complications.A variety of treatments are reported in the literature. 2 Isham introduced the first-generation percutaneous distal metatarsal osteotomy without fixation.3 This method marked the beginning of the emergence of percutaneous methods to treat HV. 4 Second-generation osteotomies fixed with Kirschner wires were performed.2,5 These procedures were accompanied by a number of significant complications, including pseudarthrosis and malunion.6 Due to these adverse outcomes, Vernois and Redfern improved the approach and described a third-generation methodology.This describes a minimally invasive Chevron-Akin osteotomy (MICA), which combines a Chevron osteotomy of the first metatarsal with an Akin osteotomy of the proximal phalanx of the hallux.The procedure is performed percutaneously using specialized burrs, with the metatarsal component stabilized by two cortical screws.