Clinical and radiological outcomes of modified Mitchell's osteotomy using three-point fixation for hallux valgus

Int Orthop. 2022 Feb;46(2):249-253. doi: 10.1007/s00264-021-05200-4. Epub 2021 Sep 1.

Abstract

Purpose: This study examined the clinical and radiographic outcomes of modified Mitchell's osteotomy using three-point fixation with a full-thread headless screw. This technique was described to resolve the problem of excessive shortening and overshifting of the metatarsal.

Methods: A total of 33 feet of 26 patients underwent modified Mitchell's osteotomy with three-point fixation for hallux valgus. Clinical and radiographic outcomes were assessed preoperatively and at specific time points of follow-up by using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale, hallux valgus angle (HVA), and intermetatarsal angle (IMA).

Results: The global AOFAS scale score (0-100) significantly improved from 50.7 ± 9.9 preoperatively to 84.4 ± 8.7 at the final follow-up. The HVA significantly improved from 30.2 [Formula: see text]± 6.0 [Formula: see text] to 9.0 [Formula: see text] ± 5.0 [Formula: see text], and the IMA significantly improved from 14.2 [Formula: see text] ± 2.6 [Formula: see text] to 5.1 [Formula: see text] ± 2.0 [Formula: see text]. None of the patients experienced nonunion and transfer metatarsalgia. Complications were observed in two feet, and one foot had recurrence of hallux valgus.

Conclusion: Modified Mitchell's osteotomy using three-point fixation with a full-thread headless screw is a reliable alternative treatment for hallux valgus, even in patients with severe deformities.

Keywords: Hallux valgus; Modified Mitchell’s osteotomy; Three-point fixation; Transfer metatarsalgia.

MeSH terms

  • Hallux Valgus* / diagnostic imaging
  • Hallux Valgus* / surgery
  • Humans
  • Metatarsal Bones* / diagnostic imaging
  • Metatarsal Bones* / surgery
  • Metatarsalgia*
  • Osteotomy / adverse effects
  • Osteotomy / methods
  • Radiography
  • Treatment Outcome