Abstract
The purpose of this study was to evaluate the outcome of a modified technique of Mitchell’s
osteotomy for treatment of moderate to severe hallux valgus deformity with the aims
of reducing first metatarsal shortening and osteonecrosis. Between February 2001 and
December 2007, a total of 69 patients (90 feet) underwent Mitchell’s corrective osteotomy
for moderate to severe hallux valgus deformity. Mean duration of follow-up after surgery
was 37 months. Clinical outcome was assessed using the AOFAS Hallux Metatarsophalangeal-Interphalangeal
score preoperatively; at 6 weeks, 6 months, 12 months postoperatively; and at annual
follow-ups thereafter. Standard weight-bearing radiographs were obtained at each visit.
Fifty-nine patients (80/90 feet, 89%) were completely satisfied, whereas 10 patients
(10/90 feet, 11%) were satisfied with minor reservations owing to minor complications.
Global AOFAS score improved from 43.7 (range, 20 to 77) preoperatively to 85.4 (range,
55 to 100) at final follow-up (P < .01). Eighty-eight (98%) of 90 feet were completely
pain free. There was a statistically significant improvement in mean hallux valgus
angle, intermetatarsal angle, and distal metatarsal articular angle at final follow-up.
There were no cases of deep infection, nonunion, or osteonecrosis of first metatarsal
head. None of the patients had shortening of the first metatarsal bone by more than
3 mm. In conclusion, our modified surgical technique with a combination of bony correction
and adequate capsular reefing is a simple procedure to correct moderate to severe
hallux valgus deformity that results in high levels of patient satisfaction, successful
deformity correction, and controlled shortening of the first metatarsal, as well as
minimal recurrence of deformity.)
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: November 25, 2010
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
