Both hamstring and patellar tendon grafts provided good subjective outcomes and objective stability at 5 years. No significant differences in the rate of graft failure were identified. Patients with patellar tendon grafts had a greater prevalence of osteoarthritis at 5 years after surgery.

From a total of 153 patients (251 feet), 64 (41.8%) patients, who had had 105 modified Mitchell procedures, were clinically and radiographically examined with follow-up periods ranging from 15 to 24 years (mean, 21 years). Mean age at operation was 41 years (range, 12-64 years). The classic double osteotomies, which diverged slightly toward the plantar surface and the distal fragment, shifted laterally, and angled plantarward, were fixed with a smooth Kirschner wire. In this way, it was possible to achieve a reduction in the first intermetatarsal angle from an average of 22.5 degrees preoperatively to 7.7 degrees postoperatively, and the hallux valgus angle changed from an average of 33 degrees to 17 degrees, with an average shortening of the first metatarsal of 5.4 mm and an average lateral displacement of the first metatarsal head of 4.5 mm. In 67 feet (64%), the results were graded good to excellent; in 23 feet (22%), satisfied; and in 15 feet (14%), poor. The results were worse than the results obtained on the same patient population with a follow-up ranging from 2 to 11 years, with 97% good-to-excellent results reported. Pain over bunion caused by recurrence of the hallux valgus deformity was the main reason for this late deterioration of the results.

No abstract