ArticleBMC musculoskeletal disorders2026
Biomechanical comparison of Mitchell versus Chevron osteotomy with the third generation minimally invasive screw fixation technique.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe Mitchell and Chevron osteotomies are two widely performed surgical techniques for the correction of hallux valgus deformities. While both approaches are commonly used, there remains limited biomechanical evidence comparing their structural stability, particularly when paired with advanced fixation techniques. This study aims to evaluate and compare the biomechanical properties of these procedures when utilizing the third-generation minimally invasive (MIS) screw fixation technique.
methodsSixteen synthetic first metatarsal (Sawbones Pacific Research Laboratories, Vashon, WA) were divided into two groups. The Mitchell osteotomy (n = 8) and the Chevron osteotomy (n = 8) were performed to simulate hallux valgus correction surgery. Both osteotomy groups were fixed using an identical technique. Two parallel, fully threaded, headless screws were positioned separately: one in a three-points fixation and the other in an intramedullary pattern. Each specimen was tested using a cantilever bending model. Following a 20-N preload, 500 cycles loading test was applied with the force ranging from 20 to 200 N (valley to peak). Interfragmentary displacement was recorded after the cyclic loading test. Finally, all specimens were subjected to destructive loading until catastrophic failure occurred.
resultsIn terms of construct stiffness, there were no significant differences (p = 0.12). The value was 321.8 ± 91.4 N/mm in the Mitchell osteotomy group and 224.3 ± 95.2 N/mm in the Chevron osteotomy group. All specimens completed the whole cyclic loading test without catastrophic failure, and the fragment displacement after 500 cycles was 1.2 ± 0.7 mm for the Mitchell osteotomy and 1.9 ± 1.1 mm for the Chevron osteotomy group (p = 0.20). No significant differences were observed between the groups regarding the ultimate failure load and failure mode.
conclusionsThe third generation MIS screw fixation technique provides comparable construct stability in both Mitchell and Chevron osteotomies, particularly in conditions requiring substantial correction. The current study offers biomechanical evidence supporting its clinical application.
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