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Modified Mitchell Bunionectomy for Management of Adolescent Hallux Valgus

This retrospective review was performed to determine results and to present a new operative method, a modified Mitchell procedure, used to treat 13 adolescents with a total of 21 bunions. The average age of the patients was 14 years, 6 months. The average clinical followup period was 31 months. The average preoperative valgus angle was 35 ° (range, 21 °-65 °); the average preoperative intermetatarsal angle was 14 ° (range, 7 °-22 °). The early operative result for 17 feet (81%) was satisfactory; deformity, pain, or stiffness recurred in 4 feet (19%). At the time of the last clinic visit, the average hallux valgus angle was 15 ° (range, 3 °-43 °); the average intermetatarsal angle was 7 ° (range, 2 °-18 °). No instances of malunion, nonunion, infection, avascular necrosis, or transfer metatarsalgia occurred. This modification of the Mitchell procedure is an effective management option for mild to moderate adolescent hallux valgus.