Robinson AH, Limbers JP: Modern concepts in the treatment of hallux valgus. .J Bone Joint Surg Br 87::1038. ,2005. .
Mitchell CL, Fleming JL, Allen R, et al: Osteotomy-bunionectomy for hallux valgus. .J Bone Joint Surg Am 40-A::41. ,1958. .
Blum JL: The modified Mitchell osteotomy-bunionectomy: indications and technical considerations. .Foot Ankle Int 15::103. ,1994. .
Kuo CH, Huang PJ, Cheng YM, et al: Modified Mitchell osteotomy for hallux valgus. .Foot Ankle Int 19::585. ,1998. .
Smith RW, Reynolds JC, Stewart MJ: Hallux valgus assessment: report of research committee of American Orthopaedic Foot and Ankle Society. .Foot Ankle 5::92. ,1984. .
Merkel KD, Katoh Y, Johnson EW Jr, et al: Mitchell osteotomy for hallux valgus: long-term follow-up and gait analysis. .Foot Ankle 3::189. ,1983. .
Madjarevic M, Kolundzic R, Matek D, et al: Mitchell and Wilson metatarsal osteotomies for the treatment of hallux valgus: comparison of outcomes two decades after the surgery. .Foot Ankle Int 27::877. ,2006. .
O’Malley MJ, Chao W, Thompson FM: Treatment of established nonunions of Mitchell osteotomies. .Foot Ankle Int 18::77. ,1997. .
Hsu CY, Cheng YM, Law CL, et al: Hallux valgus: soft tissue procedure versus bony procedure. .Gaoxiong Yi Xue Ke Xue Za Zhi 10::624. ,1994. .
Donovan JC: Results of bunion correction using Mitchell osteotomy. .J Foot Surg 21::181. ,1982. .
Kitaoka HB, Alexander IJ, Adelaar RS, et al: Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. .Foot Ankle Int 15::349. ,1994. .
Grace D, Hughes J, Klenerman L: A comparison of Wilson and Hohmann osteotomies in the treatment of hallux valgus. .J Bone Joint Surg Br 70::236. ,1988. .
Sarrafian SK: A method of predicting the degree of functional correction of the metatarsus primus varus with a distal lateral displacement osteotomy in hallux valgus. .Foot Ankle 5::322. ,1985. .
Hardy RH, Clapham JC: Observations on hallux valgus based on a controlled series. .J Bone Joint Surg Br 33-B::376. ,1951. .
Glynn MK, Dunlop JB, Fitzpatrick D: The Mitchell distal metatarsal osteotomy for hallux valgus. .J Bone Joint Surg Br 62-B::188. ,1980. .
Becirovic E: Ergonomic and biomechanical study of foot stress in workers using sewing machines [in Croatian]. .Reumatizam 36::57. ,1989. .
Mancuso JE, Abramow SP, Landsman MJ, et al: The zero-plus first metatarsal and its relationship to bunion deformity. .J Foot Ankle Surg 42::319. ,2003. .
Thordarson DB, Ebramzadeh E, Rudicel SA, et al: Age-adjusted baseline data for women with hallux valgus undergoing corrective surgery. .J Bone Joint Surg Am 87::66. ,2005. .
Pollak R, Raymond GA, Jay RM, et al: Analgesic efficacy of valdecoxib for acute postoperative pain after bunionectomy. .JAPMA 96::393. ,2006. .
Teli M, Grassi FA, Montoli C, et al: The Mitchell bunionectomy: a prospective study of 60 consecutive cases utilizing single K-wire fixation. .J Foot Ankle Surg 40::144. ,2001. .
Tomczak RL, Lewandowski JE: A meta-analysis of first metatarsal osteotomies for the correction of metatarsus primus adductus. .J Foot Surg 30::364. ,1991. .
Laird PO, Silvers SH, Somdahl J: Two Reverdin-Laird osteotomy modifications for correction of hallux abducto valgus. .JAPMA 78::403. ,1988. .
Frischhut B, Butschek R, Went P: Magerl’s subcapital osteotomy in the treatment of hallux valgus [in German]. .Orthopade 25::317. ,1996. .
Wu KK: Mitchell’s bunionectomy and Wu’s bunionectomy: a comparison of 100 cases of each procedure. .Orthopedics 13::1001. ,1990. .
Selner AJ, King SA, Samuels DI, et al: Tricorrectional bunionectomy for hallux abducto valgus. A comprehensive outcome study. .JAPMA 89::174. ,1999. .
Piper T, Sanders T, Petrov O, et al: The modified Hohmann bunionectomy: a retrospective review. .J Foot Ankle Surg 39::224. ,2000. .
Scranton PE Jr, Rutkowski R: Anatomic variations in the first ray: Part I. Anatomic aspects related to bunion surgery. .Clin Orthop Relat Res 155::244. ,1980. .
Chang JW, Griffiths H, Chan DP: A new radiological technique for the forefoot. .Foot Ankle 5::77. ,1984. .
Artz T, Rogers SC: Osteotomy for correction of hallux valgus. .Clin Orthop Relat Res 88::50. ,1972. .
Carr CR, Boyd BM: Correctional osteotomy for metatarsus primus varus and hallux valgus. .J Bone Joint Surg Am 50::1353. ,1968. .
Das De S: Distal metatarsal osteotomy for adolescent hallux valgus. .J Pediatr Orthop 4::32. ,1984. .
Barouk LS: Osteotomies of the great toe. .J Foot Surg 31::388. ,1992. .
Christensen PH, Hansen TB: Hallux valgus correction using a modified Hohmann technique. .Foot Ankle Int 16::177. ,1995. .
Klosok JK, Pring DJ, Jessop JH, et al: Chevron or Wilson metatarsal osteotomy for hallux valgus. A prospective randomised trial. .J Bone Joint Surg Br 75::825. ,1993. .
Terzis GD, Kashif F, Mowbray MA: The Mayday distal first metatarsal osteotomy for hallux valgus: a review after the introduction of a new instrument. .Foot Ankle Int 18::3. ,1997. .
Wagdy S, el-Sheshtawy OE, Megahed AH: Evaluation of Wagdy’s technique for treatment of hallux valgus by double-V osteotomy. .J Foot Ankle Surg 34::65. ,1995. .
Mitchell’s osteotomy gives very good results but there are still some cases where the original method, as well as its modification, cannot address all aspects of deformity. We modified the original Mitchell’s method to address pronation and plantar displacement of the first metatarsal. Modification includes formation of lateral and plantar spur with metatarsal displacement and derotation of distal metatarsal fragment in the frontal and horizontal planes with stable screw fixation. We present midterm results of the first 60 patients compared to the original Mitchell method (30 patients). Differences between the groups postoperatively were in declination angle, postoperative metatarsalgia rate, and first metatarsal pronation angle. The technique described eliminated many of the disadvantages of Mitchell’s method. (J Am Podiatr Med Assoc 99(2): 162–172, 2009)