Bioabsorbable Fixation for Mitchell's Bunionectomy Osteotomy

Although bioabsorbable pins have been used to successfully stabilize a wide range of osteotomies, to date there have been not published studies describing the results of their use for fixation of first metatarsal osteotomies in Mitchell's bunionectomy. The purpose of this retrospective investigation of 78 first metatarsal osteotomies was to evaluate the effectiveness of polydioxanone bioabsorbable pin fixation of the first metatarsal osteotomy in Mitchell's bunionectomy. The mean length of the first metatarsal preoperatively was 6.65 +/- 0.42 cm, and postoperatively it was 6.31 +/- 0.57 cm (P <.0001). The mean first IMA preoperatively was 17.59 degrees +/- 3.51 degrees, and postoperatively it was 9.91 degrees +/- 2.58 degrees (P <.0001). The mean HVA preoperatively was 29.74 degrees +/- 4.70 degrees, and postoperatively it was 12.89 degrees+/- 4.26 degrees (P <.0001). The average time to bony union was 6.01 +/- 0.61 weeks. There were 5 (6.41 %) superficial wound infections that resolved with oral antibiotics, 1 (1.28%) deep-seated infection requiring surgical debridement, and 2 (2.56%) patients complained of transfer metatarsalgia. Five (6.41%) patients displayed persistent localized translucency at some portion of the osteotomy site on postoperative radiographs, and there were no cases of progressive osteolysis. In this series there were no complications related to pin fracture or failure of osteotomy fixation. Based on the results observed in this study, it appears that the use of polydioxanone bioabsorbable pins provides satisfactory stabilization of the first metatarsal osteotomy in Mitchell's bunionectomy, and was not associated with any serious complications. Level of Clinical Evidence: 2 (The Journal of Foot & Ankle Surgery 48(1):9-14, 2009)