The modified Mitchell osteotomy-bunionectomy: indications and technical considerations.

A total of 204 modified Mitchell osteotomy-bunionectomy procedures with Steinmann pin fixation were evaluated by radiograph, history, and physical examination with long-term personal follow-up. The specific surgical technique modifications used in this series are discussed. This modified procedure produced 91% good or excellent results in this series. The complications or unsatisfactory results were due to partial avascular necrosis, lateral metatarsalgia, incomplete correction of hallux valgus, or late stress fractures. These unsatisfactory results led to the development of specific preoperative surgical criteria for the procedure in addition to the technical modifications.