Background  

Complications in the form of avascular necrosis, non-union, malunion have been reported following Mitchell’s osteotomy but no report of synostosis between first and second metatarsal have been reported. A case of cross union between first and second metatarsal following Mitchell’s osteotomy for hallux valgus in a 57-year-old lady is presented. This patient had Mitchell’s osteotomy on both her feet 7 years back. She presented with tingling in her toes and swelling in first web space. X-ray of the left foot showed bony bridge between distal third of first and second metatarsal.

Conclusion  

Cross union between the first and second metatarsal is rare to follow first metatarsal osteotomy. This can be symptomatic, the procedure described can cure the problem, and the condition needs to be prevented to avoid aggressive soft tissue damage and haematoma by rough handling of osteotomy displacement and not by using dorsolateral approach for hallux valgus surgery.