Proximal phalangeal osteotomies for hallux abductovalgus deformity.

The primary indication for an osteotomy of the hallux proximal phalanx to correct hallux abductovalgus (HAV) deformities is increased hallux interphalangeus. The typical osteotomy is the Akin osteotomy or a variation. The Akin is a medial closing wedge osteotomy in the proximal phalanx. An Akin-type osteotomy is usually used as an adjunctive procedure for HAV to correct deformity within the great toe. When first metatarsal procedures and soft tissue balancing are not sufficient for realigning the first metatarsophalangeal joint, an Akin can be useful. A hallux proximal phalanx osteotomy is not indicated as the primary correction for HAV deformities.