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.