The Journal of Bone and Joint Surgery, Vol 75, Issue 11 1610-1618, Copyright © 1993 by Journal of Bone and Joint Surgery, Inc
The Mitchell procedure for the treatment of adolescent hallux valgus. A long-term study
PB Canale, DD Aronsson, RL Lamont and A Manoli
Department of Orthopaedic Surgery, Children's Hospital of Michigan, Detroit 48201.
Thirty patients who had had a total of fifty-one Mitchell procedures to
correct adolescent hallux valgus deformities were examined clinically and
radiographically an average of seven years (range, three to seventeen
years) after the operation. The average age of the patients at the time of
the operation was fifteen years (range, ten to nineteen years). The result
was excellent in nineteen feet, good in sixteen, fair in six, and poor in
ten. The fair and poor results were associated with recurrence of the
deformity, stiffness (real or perceived), and unsightly scars. The cause of
the fair and poor results was inadequate correction at the time of the
operation in six feet and loss of fixation in two; the loss of fixation
resulted in one recurrence and one malunion. The remaining eight patients
who had a fair or poor result were not totally satisfied and had
reservations about more than one of three categories (relief of discomfort,
appearance, or range of motion). Seventeen feet had a plantar callosity
beneath the second metatarsal head, suggesting increased load-bearing by
the second metatarsal. Although sixteen callosities caused no symptoms at
the most recent follow-up evaluation, the long-term implications of this
altered pattern of weight-bearing are unknown.