title: Clinical and radiographic analysis of the operative procedure results according to the method of Mitchell and Keller used for correction of hallux valgus deformities.
abstract: The aim of this study is to make a correlation of the clinical and radiographic results after performing two different surgical procedures for correction of hallux valgus deformity.
  
  
  METHODS
  The study included 70 patients having hallux valgus deformity of the foot, and they were divided into two groups. The first group (Group 1) was composed of 35 patients who were treated by osteotomy of the I-st metatarsal bone according to Mitchell, while the second group (Group 2) was also composed of 35 patients who were treated by resectional arthroplasty according to Keller. Clinical (pain and metatarsalgia, as well as most dominant symptoms) and radiographic examinations (I metatarsophalangeal angle and I intermetatarsal angle) were analysed comparatively during the evaluation. The analysis of the clinical and radiographic results was performed pre-operatively and post-operatively for the two groups.
  
  
  RESULTS
  According to their sex, the patients were 5 men and 65 women. Using the method of Mitchell, pain as a clinical symptom post-operatively was found in only 3 patients out of the 35 with operated feet, while in the other group of patients treated by the method of Keller, there was no presence of pain in any of the patients. Comparatively, this does not present a statistically significant difference (p>0.05). Nor do, the differences in the distribution of metatrsalgia incidence show a statistical significance between the two groups (p>0.05). There is no significant difference (p>0.05) in the patients of the two groups concerning the pre-operative mean dimension values of the I metatarsophalangeal angle and I intermetatarsal angle. However, the radiographic analysis of the same angles in both groups, one year post-operatively, showed a high statistically significant difference (p<0.001).
  
  
  CONCLUSIONS
  Mitchell's operative technique could be recommended as an effective procedure for the correction of hallux valgus and metatarsus primus varus in young and middle-aged patients, while the resection arthroplasty according to the method of Keller is recommended for older patients with arthrotic changes.
authors.affiliation: PHI University Orthopaedic Diseases Clinic, Medical Faculty, Ss. Cyril and Methodius University, Skopje, R. Macedonia.
authors.forename: D
authors.initials: D
authors.lastname: Georgieva
authors.forename: A
authors.initials: A
authors.lastname: Poposka
authors.forename: B
authors.initials: B
authors.lastname: Zafirova-Ivanovska
mesh_terms: D000328:Adult; D018771:Arthralgia / Q000000981:diagnostic imaging / Q000209:etiology; D001178:Arthroplasty / Q000009:adverse effects / Q000379:methods; D057186:Comparative Effectiveness Research; D005260:Female; D006215:Hallux Valgus / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications; D011859:Radiography; D018843:Republic of North Macedonia