Mitchell osteotomy with herbert bone screw fixation: A retrospective analysis of 35 procedures in 22 patients with hallux valgus

Abstract

There is a plethora of options for surgical correction of moderate hallux abductovalgus deformity. The Mitchell osteotomy (1,2) is a classic procedure for hallux abductovalgus correction and has evolved through rounds of modifications since its inception and yet the optimal mode of fixation for this technique remains elusive. In this study, the utility of the Herbert bone screw fixation with a modified Mitchell osteotomy was examined. A retrospective chart review of patients that previously underwent this specific procedure at our institution between January 1, 1986 to December 31, 2002 was examined. Twenty-two patients (35 procedures) were followed for a minimum of one year and an average of three years post-operatively. Standard radiographic measurements were obtained from weightbearing AP films pre-operatively and during the immediate post-operative period at 6 weeks. The analysis revealed that the 1st intermetatarsal angle (P<0.0001), hallux abductovalgus angle (P<0.0001), and 1st metatarsal length (P<0.0001) were significantly decreased. The modified Maryland Foot Score revealed an average of 88.4% functional restoration. This study demonstrates that Herbert bone screw fixation for the Mitchell bunionectomy is an effective procedure for moderate hallux abductovalgus correction.

Keywords

• Forefoot reconstruction