Abstract
Introduction: We present a modification of surgical technique of Mitchell’s Osteotomy for hallux Valgus and the follow-up results in a consecutive series of patients operated by a single surgeon using this technique.
The modification involves: 1/not using any form of fixation of the osteotomy – neither a bone suture nor any k wires or pins. 2/a capsulodesis was preformed to correct the Hallux Valgus deformity by suturing the capsule to the distal metatarsal shaft using vicryl through 2mm drill hole.
Patients and Methods: Ninety nine patients operated on, 54 patients were seen in the clinics, 26 answered telephone questionnaire and 19 patients were unable to attend. The 54 patients who attended the clinics were examined and roentgenograms of the feet were taken. AOFAS forefoot score was used to assess the outcome.
Results: Of the 54 patients seen, 29 patients scored > 90 (AOFAS), 17 patients scored between 80 to 90 points in AOFAS and 8 patients scored < 80 points. Of the patients who answered the questionnaire, 22 patients were satisfied with the surgery and four had minor discomfort during activity. Three patients had secondary surgery for transfer metatarsalgia /hammer toes. On statistical analysis, there was no correlation between the outcome and factors such as age, degree of deformity and the post operative shortening of the first ray.
Discussion: Our surgical technique did not result in any acute instability of the osteotomy. There was no evidence of any symptomatic stiffness of the metatarsophalangeal joint because of capsulodesis.
Honorary Secretary Mr Bimal Singh. Correspondence should be addressed to BOSA (British Orthopaedic Specialists Association), c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PE.
