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Comparative study between Wilson and Mitchell metatarsal osteotomies for the treatment of hallux valgus in adults.

Although Mitchell osteotomy and Wilson osteotomy are two popular methods for the treatment of hallux valgus, there are no studies directly comparing their results. Fifty-six patients (73 feet) who underwent a Wilson osteotomy and 30 patients (34 feet) who had a Mitchell osteotomy were followed for a mean period of 33.7 and 38.9 months, respectively. The results were comparable in terms of hallux valgus angle correction and first intermetatarsal angle correction, although symptomatic improvement was higher in the Mitchell group. Moreover, the incidence of postoperative metatarsalgia was significantly lower in the Mitchell group as compared to the Wilson group (11.8% vs 32.9%), while less time was required for the patients who underwent Mitchell osteotomy to return to work or normal activities postoperatively. The difference in symptomatic improvement, incidence of postoperative metatarsalgia and rehabilitation time was even more clearly in favor of the Mitchell group in patients over 55. The increased stability at the osteotomy site offered by the Mitchell osteotomy compared to Wilson osteotomy could be the reason why patients had a lower incidence of postoperative metatarsalgia and returned to their normal activities faster, thus giving a higher satisfaction rate.