Rotation Scarf & Akin Osteotomy (RSA) : Is It Safe?

NewsBot · Apr 3, 2026

Radiation Exposure and Safety in Minimally Invasive Foot and Ankle Surgery: A Comparative Analysis Between Minimally Invasive Distal First Metatarsal Transverse Osteotomy and Akin Osteotomy vs. Open Modified Lapidus Procedure
Preston Harrison et al
J Am Acad Orthop Surg. 2026 Apr 1.

Background: Intraoperative fluoroscopy has become essential in orthopaedic surgery, particularly with the rise of minimally invasive surgery (MIS) techniques. As MIS techniques depend more on intraoperative imaging, MIS techniques may necessitate increased fluoroscopy use compared with open procedures. Despite the advantages of minimally invasive foot and ankle surgery, MIS techniques raise concerns about radiation exposure to both patients and surgical staff. The purpose of this study was to evaluate fluoroscopy time and radiation dose (cumulative air kerma) associated with open versus MIS bunion correction, comparing the open modified Lapidus procedure and the minimally invasive distal first metatarsal transverse osteotomy and akin osteotomy (META). It was hypothesized that the META procedure would be associated with increased radiation dose and fluoroscopy time compared with the open modified Lapidus procedure.

Methods: A retrospective review was conducted for patients who underwent bunion surgery between January 2021 and June 2025 by two fellowship-trained orthopaedic foot and ankle surgeons at a single academic institution. A total of 294 patients met inclusion criteria. Of these, 258 patients underwent a META procedure and 36 underwent an open modified Lapidus procedure. Fluoroscopy time (minutes) and radiation dose (mGy) were compared between the groups.

Results: A mean fluoroscopy time of 2.13 ± 1.27 (range, 0.06 to 7.05) minutes and a radiation dose of 2.02 ± 1.30 (range, 0.05 to 7.52) mGy were observed in the META cohort. An average fluoroscopy time of 1.63 ± 1.83 (range, 0.08 to 7.70) minutes and a radiation dose of 1.31 ± 1.43 (range, 0.07 to 5.98) mGy were observed in the open modified Lapidus cohort. Fluoroscopy time between the cohorts did not differ markedly ( P = 0.123); however, the META group demonstrated a higher radiation dose than the open modified Lapidus group ( P = 0.007).

Conclusion: The META procedure had a markedly higher radiation dose compared with the open modified Lapidus procedure, although both remain substantially below the International Commission on Radiological Protection recommended occupational exposure of less than 20.00 mSv per year. Despite the META procedure generating an average radiation dose of 2.02 mGy per case, surgeons receive only 0.50% of the dose; thus, nearly 1,980 procedures would be required to exceed the 20.00 mSv annual occupational limit. These findings suggest that concerns about radiation exposure should not necessarily deter providers from performing the META technique for bunion correction.
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NewsBot · May 13, 2026

K-wire versus screw fixation in Scarf-Akin osteotomy for hallux valgus: A retrospective cohort study
Yutian Qiu et al
Foot and Ankle Surgery 8 May 2026

Background
Retention of metal implants after Scarf–Akin osteotomy (SAO) may cause irritation and psychological discomfort, often necessitating a hardware removal procedure. This study aimed to introduce K-wire fixation, allowing for outpatient removal, and to compare it with screw fixation.
Methods
This retrospective study included 64 patients with hallux valgus, comprising 32 in the K-wire fixation group and 32 in the screw fixation group. Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), and patient satisfaction. Radiographic parameters included hallux valgus angle(HVA), intermetatarsal angle(IMA), and distal metatarsal articular angle(DMAA).
Results
Both groups showed significant clinical and radiographic improvement (P < 0.01). No significant between-group differences were observed in the other clinical or radiographic outcomes (P > 0.05). Treatment costs were significantly lower in the K-wire group (P < 0.001).
Conclusions
K-wire fixation provides clinical and radiographic outcomes comparable to screw fixation, while avoiding the need for an additional procedure to remove the implant.
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Rotation Scarf & Akin Osteotomy (RSA) : Is It Safe?

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

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upper body v lower body rotations, chicken or egg?

'Mean axis of rotation of the midtarsal joint' NESTER et al.

Share This Page

Rotation Scarf & Akin Osteotomy (RSA) : Is It Safe?

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Shoe Rotation in Managing Plantar Fasciitis

Rearfoot Alignment and First Metatarsal Rotation

Hip external rotation stiffness and midfoot passive mechanical resistance

The Effect of Footwear on Free Moments During a Rotational Movement in Country Swing Dance

Effect of Arch Drop on Tibial Rotation and Tibiofemoral Contact Stress

upper body v lower body rotations, chicken or egg?

'Mean axis of rotation of the midtarsal joint' NESTER et al.

Share This Page

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