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[Mitchell's osteotomy in the treatment of hallux valgus]
Insights
The Mitchell osteotomy effectively relieved painful bunions in 92% of patients, with high satisfaction regarding pain relief and foot appearance. This surgical technique is recommended when indications and surgical methods are followed.
Area of Science:
- Orthopedic Surgery
- Podiatric Surgery
Background:
- Hallux valgus, commonly known as a bunion, is a prevalent foot deformity.
- Painful bunions significantly impact patient quality of life and mobility.
- Surgical intervention is often considered for symptomatic cases unresponsive to conservative treatment.
Purpose of the Study:
- To evaluate the clinical and radiological outcomes of the Mitchell osteotomy for treating painful bunions.
- To assess patient satisfaction and functional improvement following the procedure.
Main Methods:
- Retrospective review of 91 Mitchell osteotomies performed on 63 patients.
- Average follow-up of 40 months.
- Clinical evaluation by an independent observer and weight-bearing X-rays were utilized.
Main Results:
- 92% of patients reported satisfactory pain improvement, and 93% were satisfied with the cosmetic outcome.
- The procedure achieved an average correction of 13 degrees for hallux valgus and 3.5 degrees for the intermetatarsal angle.
- 75% of patients achieved excellent or good results on the Das De scale, with a 11% rate of minor complications and no major adverse events.
Conclusions:
- The Mitchell osteotomy demonstrates high efficacy in correcting painful bunions, leading to significant pain relief and improved patient satisfaction.
- Adherence to specific indication criteria and surgical technique is crucial for optimal outcomes.
- The procedure offers a favorable safety profile with a low incidence of complications.
Abstract:
Ninety-one (91) Mitchell osteotomies on 63 patients (60 females and 3 males) were reviewed. The average follow-up was 40 months (min. 12, max. 70). The average age at the time of the surgery was 51 years (min. 20, max. 74). The presence of a apinful bunion justified the surgery in a majority of cases (92%). The clinical evaluation was done by an independent observer. Weight bearing X-rays of the feet were made in each case. The results show a satisfactory improvement of the pain in 92% of the cases. The patients were satisfied with the appearance of their foot in 93% of the cases. The average active articular range of motion was 47 degrees (min. 20 degrees, max. 120 degrees). The Das De scale showed 75% of excellent and good results. Twelve per cent (12%) of the patients presented residual metatarsalgia. We observed minor complications in 10 cases (11%). We report no cases of avascular necrosis, pseudarthrosis or infection. Clinico-radiological correlations were made. We obtained an average correction of 13 degrees (min. -5 degrees, max. 28 degrees) of the hallux valgus and 3.5 degrees (min. -7 degrees, max. 7 degrees) of the intermetatarsal angle. We recommend the Mitchell osteotomy as long as the indication criterias and the surgical technique are respected.