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MITCHELL’S OSTEOTOMY FOR HALLUX VALGUS USING 1-0 VICRYL FOR STABILISATION

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Author Details : Naseemul Gani, Hayat Ahmad Khan, Younis Kamal, Munir Farooq, Hina Jeelani, Nazia Hassan, Mohammad As

Volume : 1, Issue : 2, Year : 2015

Article Page : 116-120

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Abstract

Introduction: Hallux valgus is the one of the commonest forefoot deformities. Apart from cosmetic perspectives it can be problematic because of its pressure effects. Though common in the age group of 30-60s in females of shoe wearing population, It’s incidence in general population is also increasing. Many procedures have been documented in literature to correct such deformity. Mitchell’s osteotomy is one of the treatment options for such deformity. This osteotomy is actually two transverse osteotomies in which one is incomplete, forming a step cut. The distal fragment is displaced medially and planter-wards aiming to restore the function of the feet.

Material and Methods: Thirty patients with ten bilateral feet’s of hallux valgus deformities were operated at Bone and Joints hospital between the years 2007-2012. We had 23 females and 7 male patients with all the bilateral cases being females. The age group was between 19 years to 35 years. The follow up period was between 2 years to 7 years. The pre-operative radiograph of Antero posterior view was taken and recorded. The indications for surgery included pain, difficulty in foot wear and cosmoses.

Results: All patients were assessed according to a protocol based on the AOFAS (Smith et al 1984) and re-assessed at three-monthly intervals. Pain improved from 23 + 5.2 to 36 +5 on final follow up (max 40). Functional score improved from 31+ 4.1 to 42 +1.2 and alignment score from 3 + 2.3 to 16 +2.4 on final follow up. Overall AOFAS score improved from 58 +1.6 to 94 +8.6. Radiographic results of the procedure were also satisfactory. Preoperatively the Hallux valgus angle was 30.3 + 7.1 degrees which improved to 11.1 +4.9 degrees on final follow up. The Inter metatarsal angle also improved from a preoperative score of 15.7 + 2.9 to 7 + 2.0

Conclusion: Mitchell’s procedure is simple, cheap and can safely address the hallux valgus deformity with good postoperative function results, both clinical and radiological. Osteotomy is stable and avascular necrosis can be easily avoided by careful soft tissue handling.

Keywords: Hallux Valgus, Mitchell’s osteotomy, 1-0 Vicryl

How to cite : Gani N, Khan H A, Kamal Y, Farooq M, Jeelani H, Hassan N, Mohammad As, MITCHELL’S OSTEOTOMY FOR HALLUX VALGUS USING 1-0 VICRYL FOR STABILISATION. Indian J Orthop Surg 2015;1(2):116-120

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