OUTCOMES OF MITCHELL’S PROCEDURE IN THE TREATMENT OF HALLUX VALGUS

Authors

  • Omer Ali Rafiq Barawi Department of Orthopedic Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Abdullah K. Ghafour Shar Teaching Hospital, Sulaimani, Kurdistan Region, Iraq.
  • Abd Ali Muhsin Department of Orthopedic Surgery, College of Medicine, Al-Nahrain University, Baghdad, Iraq.

DOI:

https://doi.org/10.17656/jsmc.10380

Keywords:

Hallux valgus, Distal metatarsal osteotomy, Mitchell’s procedure, Metatarsalgia

Abstract

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).

Published

2022-12-21

How to Cite

1.
Barawi O, Ghafour A, Muhsin A. OUTCOMES OF MITCHELL’S PROCEDURE IN THE TREATMENT OF HALLUX VALGUS. JSMC [Internet]. 2022 Dec. 21 [cited 2024 Jul. 15];12(4):363-9. Available from: https://jsmc.univsul.edu.iq/index.php/jsmc/article/view/jsmc-10380

Similar Articles

1-10 of 53

You may also start an advanced similarity search for this article.