Hallux valgus is a common forefoot deformity and it’s etiology is multiple factor. The bunion pain of hallux valgus often leads to difficulty in wearing shoes and walking. If conservative treatments fail, surgery will be considered. There are many surgical methods to treat hallux valgus, and we, the foot and ankle orthopedic team in Kaohsiung Medical University Hospital, used modified Mitchell osteotomy since 1989. We have treated more than 2000 cases and have satisfactory predictable outcomes, which are published at several journals. Besides, by using clinic pathway, there are regular processes in admission, operation and follow-up to achieve goot quality, efficacy and patients’ satisfaction.
The outcomes of modified Mitchell osteotomy are as following:
- The satisfaction rate is about 96 %, which is higher than 95% published in previous study.
- The recurrence rate is less than 10 %, which is lower than most other surgical reports.
- We used compression screw to prevent the complication of pin tract infection.
- The complication rate of transfer metatarsalgia is 6 % and it’s better than other published reports.
Services and Advantages:
1. We use step-osteotomy to increase stability on osteotomy site. Besides, the step-osteotomy mildly shortens 1st metatarsal bone and loosens the
pulling force from lateral side.
2. However, the shortened 1st metatarsal bone may shift force to 2nd metatarsal bone and lead to 2nd transfer metatarsalgia. So, we used a unique
modification by plantar shifting of 1st metatarsal head to prevent 2nd transfer metatarsalgia.
3. We also can make the metatarsal head supination at osteotomy site to correct the pronated metatarsal bone in hallux valgus patients.
4. We fixed the osteotomy site by a titanium compressive screw, which improves stability on osteotomy site, enhances bony union and is easy for
post-operative care. Therefore, patient can walk even right after surgery.
The wound of modified Mitchell osteotomy is smaller than other proximal metatarsal osteotomy, and patients don’t need any casting for protection after operation. Patients can take a shower after removing stitches and walk without crutches. Due to above reasons, the quality of life is good even right after surgery.