Modified Mitchell bunionectomy for management of adolescent hallux valgus

This retrospective review was performed to determine results and to present a new operative method, a modified Mitchell procedure, used to treat 13 adolescents with a total of 21 bunions. The average age of the patients was 14 years, 6 months. The average clinical followup period was 31 months. The average preoperative valgus angle was 35 degrees (range, 21 degrees-65 degrees); the average preoperative intermetatarsal angle was 14 degrees (range, 7 degrees-22 degrees). The early operative result for 17 feet (81%) was satisfactory; deformity, pain, or stiffness recurred in 4 feet (19%). At the time of the last clinic visit, the average hallux valgus angle was 15 degrees (range, 3 degrees-43 degrees); the average intermetatarsal angle was 7 degrees (range, 2 degrees-18 degrees). No instances of malunion, nonunion, infection, avascular necrosis, or transfer metatarsalgia occurred. This modification of the Mitchell procedure is an effective management option for mild to moderate adolescent hallux valgus.