When performing bunion surgery, DPMs may be seeking a device that can correct several angles and enhance the cuts of traditional bunionectomies. Now a tried-and-true osteotomy device comes complete with new equipment to make surgery simpler. The new instrumentation is designed to help practitioners correct intermetatarsal angles in addition to proximal articular set angle (PASA).
Over a year ago, Biopro expanded its Accu-Cut™ Osteotomy Guide System with the introduction of the 2-Stage Guide for correction of PASA. The new system has a kit containing a basic guide for the initial Chevron osteotomy. Three additional guides within the kit mount to the same K-wire platform as the first stage, allowing for the precise correction of the PASA in increments of 5, 10 and 15 degrees.
“The various modifications of the Austin bunionectomy allow for a wide variety of applications in bunion surgery,” says Chris Allen, DPM, who practices in Bristol, Tenn. “The arms of the Chevron osteotomy are straightforward but need to be accurate or the procedure becomes less science and more art.”

Dr. Allen, a Clinical Assistant Professor in the Department of Family Medicine at the James H. Quillen College of Medicine at East Tennessee State University, has been using the Accu-Cut 2-Stage System since it was first released.
“The template system makes the precise parallel cuts of the traditional Austin easy,” comments Dr. Allen. “In addition, the precision of the template system with its 5, 10 and 15 degree increments has increased my confidence in the very technical cuts that are involved in bicorrectional procedures.”
He points to several instances when, after completing the second arm of the osteotomy, the capital fragment slid laterally about 5 mm into place without manipulation. “That is how precise these cuts are,” he notes.
Juan Goez, DPM, has also used the Accu-Cut 2-Stage System to correct the PASA one commonly sees in mid- to late stages of hallux abducto valgus deformities.
“The system allows for very accurate osteotomies and enhanced stability due to the fact that the system utilizes the Chevron osteotomy model,” states Dr. Goez, who has private practices in Freeport and Bellmore, N.Y. “This allows for easy rigid internal fixation with a variety of fixation systems.”
Dr. Goez, an Adjunct Professor in the Department of Surgery at the Ohio College of Podiatric Medicine and International Editor for PRESENT Educational Courseware, adds that his patients are able to return to weightbearing activities relatively early due to the stable nature of their osteotomies.

Emphasizing A Short Learning Curve
Drs. Allen and Goez praise the Accu-Cut 2-Stage System’s short learning curve.
“It comes complete with K-wires and the saw blade, which makes the system very easy for the hospital operating room personnel to handle,” says Dr. Goez.
Dr. Allen says the system’s templates are clearly labeled and that no appreciable time has been added to the length of the procedures he performs. In fact, he says the system provides him with a safety net of sorts.
“There is comfort in knowing that when you need to remove a 10-degree bone wedge, for example, the template will give you a 10-degree bone wedge,” notes Dr. Allen. “There is less fiddling and contemplation over the cuts and this probably reduces the time spent making the cuts.”
When he was a resident, Dr. Allen found the Reese osteotomy guide awkward and difficult to position. He notes that he has recommended the Accu-Cut 2-Stage System to several podiatrists who are in private practice. He has also suggested that his residency program use the system as a teaching tool.
“With this system’s ability to make precise bone cuts, this is a great way to achieve consistently accurate results even in the hands of less experienced surgical residents,” advises Dr. Allen.

Ms. Garthwait is a freelance writer who lives in Downingtown, Pa.