Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jun;33(3):701-6.
doi: 10.1007/s00264-008-0664-2. Epub 2008 Oct 28.

Fixation of Mitchell's osteotomy with bioabsorbable pins for treatment of hallux valgus deformity

Vassilios S Nikolaou  1 , Demitrios Korres, Fragiskos Xypnitos, John Lazarettos, Stergios Lallos, Georgios Sapkas, Nicolas Efstathopoulos
Affiliations

Fixation of Mitchell's osteotomy with bioabsorbable pins for treatment of hallux valgus deformity

Vassilios S Nikolaou et al. Int Orthop. 2009 Jun.

Abstract
in English, French

We hypothesised that the use of bioabsorbable pins in Mitchell's osteotomy would improve the outcome of patients treated for hallux valgus deformity. A total of 68 patients underwent Mitchell's osteotomy to correct hallux valgus deformity: 33 patients (group A) underwent Mitchell's osteotomy augmented with bioabsorbable pins and 35 patients were treated with the classic operative procedure (group B). Hallux valgus angle (HVA), intermetatarsal angle (IMA), the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale and the visual analogue score (VAS) for pain were measured preoperatively and postoperatively. There was no statistically significant difference between the two groups as far as the improvement of the IMA, HVA and AOFAS scale were concerned. Patients of group A had significantly less postoperative pain and returned to their previous activities earlier than patients of group B. The use of the pins did not improve the final outcome of the osteotomy. However, it allowed for faster rehabilitation due to less postoperative pain.

nous faisons l’hypothèse que l’utilisation de broches résorbables dans la technique d’ostéotomie de type Mitchell doit améliorer les suites des patients traités pour un hallux valgus. 68 patients ont bénéficié d’une ostéotomie de type Mitchell pour corriger un hallux valgus, 33 patients (groupe A) ont été traités selon cette ostéotomie avec des broches résorbables et 35 patients (groupe B) ont été traités selon la méthode classique. L’angle de l’hallux valgus (HVA), l’angle intermétatarsiens (IMA), le gradiant métatarsien et interfalangien AOFAS ainsi que la douleur mesurée par échelle analogique ont été mesurés en préopératoire et en postopératoire. il n’y a pas de différences significatives entre ces deux groupes en ce qui concerne L’IMA, L’HVA et L’AOFAS. Les patients du groupe A ont, de façon significative, moins de douleur post-opératoire et un retour à l’activité plus rapide que les patients du groupe B. L’usage de ces broches améliore donc le devenir de ces patients permettant une rééducation plus rapide du fait de la diminution des douleurs post-opératoires.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Bioabsorbable pins made of poly(p-dioxanone) were used for the augmentation of Mitchell’s osteotomy
Fig. 2
Fig. 2
a Using a 1.5-mm K-wire a hole was created through the osteotomy, beginning at the medial cortex of the metatarsal shaft proximal to the osteotomy and ending at the lateral side of the osteotomised head of the metatarsal. b The bioabsorbable pin was inserted into the full length of the hole. The portion of the pin that protruded was removed
Fig. 3
Fig. 3
Postoperatively all patients received a standard bunion dressing with extra support by Zimmer splint
Fig. 4
Fig. 4
Preoperative (left), immediate postoperative (middle) and 12 weeks postoperative (right) anteroposterior weight-bearing radiographs of a patient treated with bioabsorbable pin
Fig. 5
Fig. 5
Changes at the intermetatarsal angle (chart 1) and the hallux valgus angle (chart 2) in the two patient groups. Left columns: preoperative values, middle columns: values obtained at the first postoperative appointment, right columns: values obtained at the latest follow-up
See this image and copyright information in PMC

References

    1. Bhatia S, Shalaby SW, Powers DL, Lancaster RL, Ferguson RL. The effect of site of implantation and animal age on properties of polydioxanone pins. J Biomater Sci Polym Ed. 1994;6(5):435–446. doi: 10.1163/156856294X00428. - DOI - PubMed
    1. Blum JL. The modified Mitchell osteotomy-bunionectomy: indications and technical considerations. Foot Ankle Int. 1994;15(3):103–106. - PubMed
    1. Bonner AC., Jr Rigid internal fixation of the Mitchell-Hawkins osteotomy/bunionectomy with the Herbert Bone Screw. J Foot Surg. 1986;25(5):390–393. - PubMed
    1. Briggs TW, Smith P, McAuliffe TB. Mitchell’s osteotomy using internal fixation and early mobilisation. J Bone Joint Surg Br. 1992;74(1):137–139. - PubMed
    1. DeFronzo DJ, Landsman AR, Landsman AS, Stern SF. Austin bunionectomy with 3M Staplizer fixation. An assessment of 20 cases. J Am Podiatr Med Assoc. 1991;81(3):140–149. - PubMed