Screw versus suture fixation of Mitchell's osteotomy. A prospective, randomised study

Area of Science:

• Orthopedic surgery
• Foot and ankle reconstruction

Background:

• Mitchell's osteotomy is a surgical procedure for forefoot deformities.
• Traditional fixation methods involve sutures and prolonged immobilization.
• Early mobilization may improve patient outcomes and reduce recovery time.

Purpose of the Study:

• To compare the efficacy of cortical screw fixation versus suture fixation for Mitchell's osteotomy.
• To evaluate the impact of fixation method on patient recovery and satisfaction.

Main Methods:

• Prospective study of 30 patients undergoing Mitchell's osteotomy.
• Two fixation groups: suture with immobilization vs. cortical screw with early mobilization.
• Outcomes assessed included return to social activities, work, patient satisfaction, footwear status, and forefoot scores.

Main Results:

• Screw fixation group returned to social activities and work significantly earlier (2.9 and 4.9 weeks vs. 5.7 and 8.7 weeks).
• Higher patient satisfaction and earlier return to normal footwear observed with screw fixation at 6 weeks.
• Forefoot scores improved significantly more with screw fixation at 6 weeks and 3 months.
• Two screws were removed at one year due to site pain.

Conclusions:

• Internal fixation with a cortical screw facilitates safe early mobilization after Mitchell's osteotomy.
• Screw fixation significantly reduces patient convalescence time compared to suture fixation.
• While effective, potential screw head site pain should be considered.