Mitchell osteotomy for adolescent hallux valgus

Sixty-nine Mitchell osteotomies augmented with smooth-pin fixation and a trapezoidal step-off osteotomy to maintain ray length were performed on 46 adolescent patients with a painful hallux valgus deformity. Average follow-up time was 6 years. By using radiographic, clinical, and subjective patient data, we found an overall excellent or good result in 91% of cases. Nine feet were found to be cosmetically unsatisfactory, 11 required special shoewear, 10 had mild residual pain with high heels or strenuous running, and three had pain severe enough to restrict activities. Range of motion was normal in 56 feet, slightly decreased in 11 feet, and significantly reduced in two feet. We conclude that, given a success rate of 91%, this slightly modified Mitchell osteotomy is a satisfactory procedure for adolescent hallux valgus deformity with chronic bunion discomfort.