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The Mitchell bunionectomy: a prospective study of 60 consecutive cases utilizing single K-wire fixation
M Teli1, F A Grassi, C Montoli
1Institute of Orthopedics, University of Insubria, Ospedale di Circolo, Varese, Italy. marcoteli@hotmail.com
Summary
A modified Mitchell osteotomy using Kirschner wire fixation is safe and effective for hallux valgus surgery. This technique improved patient scores and radiographic angles, allowing early weightbearing.
Area of Science:
- Orthopedic Surgery
- Podiatric Medicine
- Biomechanical Engineering
Background:
- Hallux valgus is a common foot deformity.
- Traditional surgical correction methods can involve prolonged immobilization.
- Minimally invasive techniques are sought to improve patient outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of a modified Mitchell osteotomy with Kirschner wire fixation for hallux valgus.
- To assess clinical outcomes and radiographic changes following the procedure.
- To determine the feasibility of early weightbearing after surgery.
Main Methods:
- Prospective evaluation of 45 patients (60 feet) with hallux valgus.
- Surgical procedure: modified Mitchell osteotomy with Kirschner wire fixation.
- Early weightbearing allowed post-operatively without casting.
Main Results:
- Mean American Orthopedic Foot and Ankle Society (AOFAS) hallux score improved from 44.6 to 83.2.
- Radiographic correction: mean MTP angle decreased from 31.7° to 16.9°, mean IMA decreased from 15.4° to 8.6°.
- Complications: 4% short-term loss of correction, 10% unrelieved metatarsalgia.
Conclusions:
- Kirschner wire stabilization of the Mitchell osteotomy is a safe and effective surgical option.
- The procedure yields significant clinical and radiographic improvements for mild to moderate hallux valgus.
- Early weightbearing is feasible and does not compromise short-term outcomes.