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Masters Thesis | Orthopaedic Surgery | Egypt | Volume 12 Issue 3, March 2023
A Retrospective Study of Hallux Valgus Deformity Correction by Modified Mitchell Osteotomy and K - Wire Fixation
Waleed Arafat El Tohamey | Nehad Mahmoud El - Mahboub | Ahmed Farid Mahmoud Farid | Assem Bastawisy Ahmed
Abstract: Background: Hallux valgus (HV), also known as a bunion, it is considered to be one of the most common forefoot deformities. It manifests with the proximal phalanx deviating laterally and the first metatarsal head deviating medially. It is usually due to the adduction of the first metatarsus, called metatarsus primus Varus. The exact etiology is not fully understood. It tends to occur more commonly in women and those who wear tight shoes or high heels. HV deformity is typically diagnosable through a physical exam. However, imaging is important as it can evaluate whether there is damage to the first metatarsophalangeal (MTP) joint and to know the degree of deformity. Objective: To evaluate the clinical and radiological outcome of modified Mitchell technique with additional K wire fixation in patients with hallux valgus deformity. Patients and Methods: Fourty patients complaining of hallux valgus deformity after failure of conservative treatment were included in the study to undergo a modified Mitchell technique for treatment of their hallux valgus deformity, with follow up of 6 months to 18 months. The study included 30 females (60%) and 10 males (40%). The age of the patients ranged from 19 to 58 years with mean 47.8 years. There were 22 (55%) right - sided and 18 (45%) left - sided. Results: Regarding hallux IPJ motion (plantar flexion), at 3 - month follow up, 37 patients scored 5 points (No restriction) and 3 patients scored 0 point [severe restriction (less than 10) ]. After 6 months, all patients scored 5 points. Regarding hallux MTP - IP stability (all directions), all patients scored 5 points (stable). Regarding callus related to hallux MTPJ or IPJ, all patients scored 5 points (no callus or asymptomatic callus). Regarding hallux alignment, 38 patients scored 15 points (good, hallux well aligned) and 2 patients scored 8 points (fair, some hallux malalignment, asymptomatic). Conclusion: The short - and long - term results of this modified Mitchell?s osteotomy with fixation by a K - wire have been reported. It has been statistically proven to be a reliable, reproducible, cost - efficient surgical technique, with low complication rates with satisfactory clinical outcomes.
Keywords: Hallux valgus, metatarsophalangeal
Edition: Volume 12 Issue 3, March 2023,
Pages: 1275 - 1282