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Clinical and radiological outcomes of modified Mitchell's osteotomy using three-point fixation for hallux valgus
Sheng-Pin Lo1, Chen-Hao Chiang1, Chang-Hao Lin2
1Department of Orthopaedics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, No. 539, Zhongxiao Rd., East Dist., Chiayi City, 60002, Taiwan.
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.
