The Mitchell bunionectomy: a prospective study of 60 consecutive cases utilizing single K-wire fixation.
The authors prospectively evaluated 45 patients (60 feet) affected by hallux valgus and treated with a distal metatarsal osteotomy. The surgical procedure consisted of a modified Mitchell osteotomy, in which fixation was achieved with a Kirschner wire that was driven into the proximal osteotomy fragment and buttressed the distal one. Early weightbearing was allowed without a cast. Follow-up averaged 25 months. The mean American Orthopedic Foot and Ankle Society clinical hallux score increased from 44.6/100 preoperatively to 83.2/100. Radiographic evaluation showed that mean metatarsophalangeal and intermetatarsal angles decreased respectively from 31.7 degrees to 16.9 degrees, and from 15.4 degrees to 8.6 degrees. Short-term loss of correction occurred in three cases (4%). Six feet (10%) had unrelieved metatarsalgia that was related to excessive shortening of the first metatarsal and/or inappropriate orientation of the metatarsal head. Stabilization of the Mitchell osteotomy with a Kirschner wire proved safe and effective for the surgical correction of mild to moderate hallux valgus.
Teli
M
M
Institute of Orthopedics, University of Insubria, Ospedale di Circolo, Varese, Italy. marcoteli@hotmail.com
Grassi
F A
FA
Montoli
C
C
Moalli
S
S
Pazzaglia
U E
UE
D000328:Adult; D000368:Aged; D001864:Bone Wires; D005260:Female; D005529:Foot Bones / Q000000981:diagnostic imaging / Q000601:surgery; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation; D011182:Postoperative Care; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D013640:Tarsal Joints / Q000000981:diagnostic imaging