Please use this identifier to cite or link to this item: https://scholarhub.balamand.edu.lb/handle/uob/5238
Title: Modified Mitchell technique for treating hallux valgus: Retrospective case series on a Middle-Eastern population and literature review
Authors: Ayoubi, Rami
Darwish, Mohammad
Aouad, Dany
Maalouly, Joseph
Hanna, Jason
Abboud, Ghadi
Cortbawi, Chawki
Affiliations: Faculty of Medicine 
Keywords: Foot surgery
Hallux valgus
Modified Mitchell's osteotomy
Issue Date: 2021-05
Part of: Annals of Medicine and Surgery
Volume: 65
Abstract: 
Introduction
The hallux valgus deformity is a complex deformity of the first ray of the foot, with more than 100 procedures developed for its treatment. The aim of this retrospective study was to assess the clinical and radiographic outcomes of a modified Mitchell's technique.

Methods
Between 2007 and 2018, 75 patients underwent the procedure. Clinical results were assessed by the AOFAS score. Radiological studies were evaluated by measuring pre-operative and post-operative HVA and IMA angles as well as the relative shortening of the first metatarsal.

Results
Of the initial 75 patients, 42 patients remained eligible with a total of 67 feet. The mean age and follow-up were 47.8 and 5.2 years respectively. Global AOFAS score improved from 45.3 to 88.8 (p < 0.01). Mean HVA and IMA improved from 37.0 to 10.2 (p < 0,01) and 12.1 to 5.6 (p < 0.01), respectively. The mean metatarsal shortening was 3.0 mm (p < 0.01). The statistical analysis showed no significant correlation between preoperative HVA and IMA angles with postoperative shortening, metatarsalgia, AOFAS scores nor the difference between the preoperative and postoperative AOFAS scores.

Conclusion
Short- and long-term outcomes of this modified Mitchell's osteotomy have been reported. Compared to other studies, these modifications proved to result in very good clinical and radiological outcomes even in severe cases with HVA>40. It has shown to be reliable, reproducible, and cost-efficient with low complication rates. We would like to highlight the importance of proper patient selection, limited soft tissue stripping, and adherence to the proposed surgical steps to avoid unwanted complications.
URI: https://scholarhub.balamand.edu.lb/handle/uob/5238
ISSN: 2049-0801
DOI: 10.1016/j.amsu.2021.102259
Open URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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