title: Screw versus suture fixation of Mitchell's osteotomy. A prospective, randomised study.
abstract: We studied prospectively 30 patients who had a Mitchell's osteotomy secured by either a suture followed by immobilisation in a plaster boot for six weeks, or by a cortical screw with early mobilisation. The mean time for return to social activities after fixation by a screw was 2.9 weeks and to work 4.9 weeks, which was significantly earlier than those who had stabilisation by a suture (5.7 and 8.7 weeks, respectively; p < 0.001). Use of a screw also produced a higher degree of patient satisfaction at six weeks, and an earlier return to wearing normal footwear. The improvement in forefoot scores was significantly greater after fixation by a screw at six weeks (p = 0.036) and three months (p = 0.024). At one year, two screws had been removed because of pain at the site of the screw head. Internal fixation of Mitchell's osteotomy by a screw allows the safe early mobilisation of patients and reduces the time required for convalescence.
authors.affiliation: Department of Orthopaedics, Central Middlesex Hospital, London, England, UK.
authors.forename: J D
authors.initials: JD
authors.lastname: Calder
authors.forename: J P
authors.initials: JP
authors.lastname: Hollingdale
authors.forename: M F
authors.initials: MF
authors.lastname: Pearse
mesh_terms: D000328:Adult; D000368:Aged; D001863:Bone Screws; D005260:Female; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D013536:Suture Techniques