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Preservation of the Length of the First Metatarsal after Modified Mitchell’s Osteotomy for Hallux Valgus Deformity. Overview, Technique and Preliminary Results

Vlamis John, Karampinas K. Panagiotis, Polizois V, Evangelopoulos S. Dimitrios and Pneumaticos G. Spyridon

Background: Mitchell’s osteotomy is considered an effective treatment option for patients with moderate hallux valgus deformity. Common complications include shortening of the first metatarsal bone as well as inadequate correction. We present an overview of the technique and propose a new modification in an attempt to improve congruity of the metatarsophalangeal joint angle and minimize metatarsal shortening. Preliminary results are reported.

Methods: 9 patients (11 feet) were operated using the new osteotomy. All patients were evaluated postoperatively and at 2 year follow up by means of the hallux metatarsophalangeal-interphalangeal score (HMIS) of the AOFAS.

Results: Postoperatively, there was no pain in the first MTP joint, no deformity or signs of local inflammation. Average HMIS and AOFAS scores were found significantly improved at the second year follow up.

Conclusion: The new technique displays good results for the correction of moderate hallux valgus deformities and preserves the length of the metatarsal bone.