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Treatment of Hallux Valgus with Three-dimensional Modification of Mitchell’s Osteotomy

Technique and Results

Ivica Lucijanic, MD, PhD ^*, Goran Bicanic, MD , Zdenko Sonicki, MD, PhD , Maja Mirkovic, MD  and Marko Pecina, MD, PhD 

^* Department of Orthopaedic Surgery, General Hospital Karlovac, Karlovac, Croatia.
Department of Orthopaedic Surgery, School of Medicine, University of Zagreb, Zagreb, Croatia.
Department for Medical Statistics, Epidemiology, and Medical Informatics, Andrija Stampar School of Public Health, Zagreb, Croatia.
Outpatients Orthopaedics, Clinic "Kinematika," Zagreb, Croatia.

Corresponding author: Goran Bicanic, MD, Department of Orthopaedic Surgery, School of Medicine, University of Zagreb, Salata 7, 10000, Zagreb, Croatia. (E-mail: goran.bicanic{at}zg.t-com.hr)

Abstract

Mitchell’s osteotomy gives very good results but there are still some cases where the original method, as well as its modification, cannot address all aspects of deformity. We modified the original Mitchell’s method to address pronation and plantar displacement of the first metatarsal. Modification includes formation of lateral and plantar spur with metatarsal displacement and derotation of distal metatarsal fragment in the frontal and horizontal planes with stable screw fixation. We present midterm results of the first 60 patients compared to the original Mitchell method (30 patients). Differences between the groups postoperatively were in declination angle, postoperative metatarsalgia rate, and first metatarsal pronation angle. The technique described eliminated many of the disadvantages of Mitchell’s method. (J Am Podiatr Med Assoc 99(2): 162–172, 2009)