OUTCOMES OF MITCHELL’S PROCEDURE IN THE TREATMENT OF HALLUX VALGUS
DOI:
https://doi.org/10.17656/jsmc.10380Keywords:
Hallux valgus, Distal metatarsal osteotomy, Mitchell’s procedure, MetatarsalgiaAbstract
Background
Hallux Valgus is the commonest foot deformity. It is characterized by lateral deviation of the big toe with the medial shifting of the first metatarsal. Many intrinsic and extrinsic factors are claimed to be a cause and may coexist as multifactorial. Mitchell’s distal metatarsal osteotomy is one of the preliminary operations proposed in managing hallux valgus, with 70% to 90% of satisfactory results.
Objectives
To evaluate the outcome of Mitchell’s procedure in treating mild to moderate hallux valgus in terms of clinical and radiological outcomes.
Patients and Methods
Sixteen adult patients (26 feet) with mild to moderate hallux valgus were enrolled in this study. They underwent original Mitchell’s step-cut distal osteotomy to correct their hallux valgus
Results
At the last follow-up, overall satisfaction was (81.25%) with three patients unsatisfied due to transfer metatarsagia and reflex sympathetic dystrophy. The mean change in hallux valgus angle and intermetatarsal angle were (17.27°) and (4.47°) respectively.
Conclusion
Mitchell’s procedure is a distal metatarsal osteotomy which has good results in treating mild to moderate hallux valgus in terms of clinical and radiological appearance and acceptable patient satisfaction. However, transfer metatarsalgia and recurrence of deformity are two more known drawbacks of this procedure.
References
Bowyer G., Uglow M. The ankle and foot. Blom A., Warwick D., Whitehouse M. Apley and Solomon’s System of Orthopaedics and Trauma. 10th Ed. Boca Raton: CRC Press, [2017]: 626 – 629.
Morphy G. Disorders of the hallux. Azar F., Beaty J., Canale S. Campbell’s Operative Orthopaedics. 13th Ed. Philadelphia: Elsevier, Inc. [2017]: 3922 – 4012.
Nix S, Smith M, Vicenzino B. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res. (September 2010), 27; 3: 21. DOI: https://doi.org/10.1186/1757-1146-3-21
Easley M., Tranka H. Current Concepts Review: Hallux Valgus Part 1: Pathomechanics, Clinical Assessment, and Nonoperative Management. Foot Ankle Int (2007), 28: 654. DOI: https://doi.org/10.3113/FAI.2007.0654
McKean J., Park J. Hallux Valgus [internet]. Orthobullets [May 2016]. Available from: https://www.orthobullets.com/foot-and-ankle/7008/hallux-valgus
Coughlin M., Jones C. Hallux Valgus: Demographics, Etiology, and Radiographic Assessment. Foot Ankle Int (2007), 28: 759. DOI: https://doi.org/10.3113/FAI.2007.0759
Glynn M., Dunlop J., Patrick D. The Mitchell Distal Metatarsal Osteotomy for Hallux Valgus. J Bone Joint Surg. (May 1980); Vol.62-B, No. 2. 188 – 191. DOI: https://doi.org/10.1302/0301-620X.62B2.7364833
Kilmartin T., Wallace W. The Aetiology of Hallux Valgus: A Critical Review of the Literature. The Foot (1993) 3. 157 – 167. DOI: https://doi.org/10.1016/0958-2592(93)90001-J
Mann R., Coughlin M. Hallux Valgus-Etiology, Anatomy, Treatment and Surgical Considerations. Clinical Orthopedics Related Research. (June 1981) No. 157: 31 – 41. DOI: https://doi.org/10.1097/00003086-198106000-00008
Steel M. 3rd, Johnson K., DeWitz M., IIstrup D. Radiographic Measurements of the Normal Adult Foot. Foot Ankle. (November 1980) 1(3): 151- 158. DOI: https://doi.org/10.1177/107110078000100304
Saltzman CL, Brands EA, Berbaum KS, DeGnore L, Holmes JR, Katcherian DA, Teasdall RD, Alexander IJ. Reliability of Standard Foot Radiographic Measurements. Foot Ankle Int. (December 1994) 15(12): 661-665. DOI: https://doi.org/10.1177/107110079401501206
Coughlin M., Saltzman C. and Nunley J. Angular Measurements in the Evaluation of Hallux Valgus Deformities: A Report of the Ad Hoc Committee of the American Orthopædic Foot & Ankle Society on Angular Measurements. Foot Ankle Int (January 2002) 23: 68 – 74. DOI: https://doi.org/10.1177/107110070202300114
Coull R., Stephens M. Operative decision making in hallux valgus. Current Orthopaedics (2002) 16, 180 – 186. DOI: https://doi.org/10.1054/cuor.2002.0270
Robinson A., Limbers J. Modern concepts in the treatment of hallux valgus. J Bone Joint Surg [Br] (August 2005); 87-B: 1038-1045 DOI: https://doi.org/10.1302/0301-620X.87B8.16467
Merkel K., Katoh Y., Johnson J., Chao E. Mitchell Osteotomy for Hallux Valgus: Long-term Follow-up and Gait Analysis. Foot & Ankle (1983) Vol. 3, No.4: 189 – 196. DOI: https://doi.org/10.1177/107110078300300402
Blum JL. The modified Mitchell osteotomy-bunionectomy: indications and technical considerations. Foot Ankle Int. (March 1994)15(3): 103-106. DOI: https://doi.org/10.1177/107110079401500304
Shapiro R., Heller L. The Mitchell Distal Metatarsal Osteotomy in The Treatment of Hallux Valgus. Clinical Orthopaedics. And Related Research (March 1975) No. 107: 226 – 231 DOI: https://doi.org/10.1097/00003086-197503000-00026
Dermon A., Tilkeridis C., Lyras D., Tryfonidis M., Petrou C., Tzanis S., Kazakos K., Petrou G. Long-term Results of Mitchell’s Procedure for Hallux Valgus Deformity: A 5- to 20-year Follow-up in 204 Cases. Foot & Ankle International. (January 2009) Vol. 30, No. 1; 16 -20. DOI: https://doi.org/10.3113/FAI.2009.0016
Baba A., Bhat J., Paljor S., Mir N. and Majid S. Mitchell's osteotomy in managing hallux valgus: An Indian perspective. Indian J Orthop. 2009 Jan-Mar; 43(1): 76–81. DOI: https://doi.org/10.4103/0019-5413.45327
Kalender A., Uslu M., Bakan B., Ozkan F., Erturk C Altay M., Guner S. and Kalender M. Mitchell’s Osteotomy with Mini-Plate and Screw Fixation for Hallux Valgus. Foot & Ankle International (2013) Vol. 34 No.2: 238– 243. DOI: https://doi.org/10.1177/1071100712465392
McDonald M., Stevens D. Modified Mitchell Bunionectomy for Management of Adolescent Hallux Valgus. Clinical Orthopaedics , and Related Research (November 1996) No. 332: 163-169 DOI: https://doi.org/10.1097/00003086-199611000-00022
David-West K. Complications associated with Mitchell’s Osteotomy for Hallux Valgus Correction: A retrospective hospital review. The Foot and Ankle Online Journal (March 2011): vol. (4) No. (3). DOI: https://doi.org/10.3827/faoj.2011.0403.0001
Prior T., Grace D., MacLeanJ., Allen P., Chapman G., Day A. Correction of hallux abductus valgus by Mitchell’s metatarsal osteotomy: comparing standard fixation methods with absorbable polydioxanone pins. The Foot (1997) No.7: 121-125. DOI: https://doi.org/10.1016/S0958-2592(97)90020-1
Canale P., Aronsson D., Lamont R., Manoli A. The Mitchell Procedure for the Treatment of Adolescent Hallux Valgus-A Long-Term Study. J Bone Joint Surg (November 1993), Vol.75-A, No.11. 1610 – 1618 DOI: https://doi.org/10.2106/00004623-199311000-00005
Calder J., Hollingdale J., Pearse M. Screw versus suture fixation of Mitchell’s osteotomy: A Prospective, Randomised Study. J Bone Joint Surg [Br] 1999; 81-B: 621-624. DOI: https://doi.org/10.1302/0301-620X.81B4.0810621
Coughlin M., Mann R. Hallux Valgus. Coughlin M., Mann R., Saltzman C. Surgery of The Foot and Ankle. 8Th Ed. Vol 11, by Mosby, Inc., an affiliate of Elsevier Inc. [2007]: 183 – 362).
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Omer Ali Rafiq Barawi, Abdullah K. Ghafour, and Abd Ali Muhsin
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This work is licensed under 