Long-term results after Mitchell osteotomy in children and adolescents with hallux valgus

The current study elucidates the quality of long-term results after hallux valgus correction by Mitchell osteotomy in children and adolescents. Eight female and 1 male hallux valgus patient with a total of 16 bunion deformities underwent a Mitchell procedure in the period 1970 to 1985, and were reinvestigated in December 1994 (at an average of 16 years later). Their ages at operation ranged from 9 to 20 years (average 16 years). Patients' data were subdivided into subjective and objective criteria. Subjective parameters such as pain, shoe fitting, mobility and cosmesis were assessed by interview. Objective data were obtained from reports, radiographs and physical examination. Owing to the lack of established and recommended scores, we developed our own evaluation pattern. Overall outcome was judged as good in 69%, satisfying in 12% and dissatisfying in 19% by both patients and surgeon. In our experience, Mitchell osteotomy is an appropriate method for young hallux valgus patients, especially in forefeet with rigid malformation or moderately severe hallux valgus and metatarsus primus varus. Extensive metatarsal shortening should be excluded preoperatively in order to avoid postoperative metatarsalgia.