I I often do triple osteotomy of the first ray in young women; no complications but with open procedure and miniplate fixation on the proximal metatarsal osteotomy, screw fixation on the distal chevron osteotomy; an Aitkin is always associated  and fixed with à screw; a long incision on y the medial side of the foot has a discreet scare

Thanks for your response. Good to know there is (almost) nothing to fear in adding Akin procedure. Though, we prefer TMT I arthrodesis rather than proximal metatarsal osteotomy, at least in flatfoot.

I always do scarf plus akin osteotomy. 

Akin osteotomy although is simple but able to make final adjustment and also prevent too tight medial capsulorrhaphy

For flatfeet. Sometime I insert hyprocure

I treat this cases with my V-tek System. This is an intramedullary fixation system which offers a Base Osteotomy in combination with a TMT-I Arthrodesis.You get a big correction potential and patient can load immediately after surgery due to great stability of the anglestable implants. See more www.halluxvalgus.at

I do chevron mostly, sometoimes with a very long plantar cut (similar to scarf);  akin just as needed. If the TMT1 is instable, I fuse it. Otherwise the foot biomechanic is altered and a stiff gait results, pushing arthrosis.