The Mitchell distal metatarsal stepcut osteotomy for the treatment of hallux valgus is a technically demanding procedure with a high complication rate. Reported complications include metatarsal shortening with lateral metatarsalgia, partial avascular necrosis of the distal fragment, and loss of position with incomplete correction. Nonunion, however, has only rarely been reported. We describe our experience with the treatment of three nonunions of Mitchell osteotomies reconstructed using a tricortical iliac crest bone graft.
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References
1.
. AuerbachA. M.: Review of distal metatarsal osteotomies for hallux valgus in the young. Clin. Orthop., 70: 148–151, 1970.
2.
. BallJ.SullivanJ. A.: Treatment of the juvenile bunion by Mitchell osteotomy. Orthopedics, 8: 1249–1252, 1985.
3.
. BlumJ. L.: The modified Mitchell osteotomy-bunionectomy: indications and technical considerations. Foot Ankle Int., 15: 103–106, 1994.
4.
. BonnerA. C.: Rigid internal fixation of the Mitchell-Hawkins bunionectomy. J. Foot Surg., 25: 390–393, 1986.
5.
. CarrC. R.BoydB. M.: Correctional osteotomy for metatarsus primus varus and hallux valgus. J. Bone Joint Surg., 50A: 1353–1367, 1968.
6.
. GlynnM. K.DunlopJ. B.FitzpatrickD.: The Mitchell distal metatarsal osteotomy for hallux valgus. J. Bone Joint Surg., 62B: 188–191, 1980.
7.
. HawkinsF. B.MitchellC. L.HedrickD. W.: Correction of hallux valgus by metatarsal osteotomy. J. Bone Joint Surg., 27: 387–394, 1945.
8.
. MeirP. J.KenzoraJ. E.: The risks and benefits of distal first metatarsal osteotomies. Foot Ankle, 6: 7–17, 1985.
9.
. MerkelK. D.KatohY.JohnsonE. W.ChaoE. Y.: Mitchell osteotomy for hallux valgus: long term follow-up with gait analysis. Foot Ankle, 4: 189–193, 1983.
10.
. MillerJ. W.: Distal first metatarsal displacement osteotomy. J. Bone Joint Surg., 62B: 188–191, 1980.
11.
. MitchellC. L.FlemingJ. L.AlienR.GlenneyC.SanfordG. A.: Osteotomy-bunionectomy for hallux valgus. J. Bone Joint Surg., 40A: 41–60, 1958.
12.
. ShapiroF.HellerL.: The Mitchell distal metatarsal osteotomy in the treatment of hallux valgus. Clin. Orthop., 107: 225–231, 1975.
13.
. SherefM. J.SobelM.KummerF.: The stability of fixation of first metatarsal osteotomies. Foot Ankle, 11: 208–211, 1991.
14.
. SzabokyG. T.RaghavenV. C.: Modification of Mitchell's lateral displacement angulation osteotomy. J. Bone Joint Surg., 51A: 1430–1431, 1969.
15.
. WuK.: Mitchell bunionectomy: clinical analysis of 150 personal cases. J. Foot Surg., 31: 282–297, 1992.