Background: Of all the osteochondrosis, Freiberg’s disease is reported to be the fourth most common,
exceeded by Köhler’s disease, Panner’s disease, and Sever’s disease. This disease usually occurs in the
2nd metatarsal head and relatively in the 3rd and 4th metatarsal heads.
Objective: The purpose of this study was to evaluate the outcome of debridement, synovectomy, dorsal
closing wedge osteotomy and pin fixation for Freiberg’s disease treatment.
Methods: Ten female patients, mean age 18.3 years; (ranged 14–24 years) were treated by the above
mentioned technique. The main presenting symptom was pain on walking or sport; affected their daily
life and activities and was not improved by non-surgical treatment. The second metatarsal head was
affected in all patients. Halve of patients had a history of trauma. According to Smillie’s classification,
four patients were type V and six patients were type IV. Mean follow-up period was 19.2 months (range
6–36 months).
Results: Were assessed by the Lesser Metatarsophalangeal-Interphalangeal (LMPI)Scale by Kitaoka et al.
At the final follow up, scoring was changed from (44–76) with an average 57 to (66–100) with an average
80. There was no case of infection, avascular necrosis, arthritis or pseudoarthrosis.
Conclusion: We founded that dorsiflexion osteotomy of the metatarsal head is presented as a logical
procedure that is simple, reliable, not destructive, and capable of good results regardless of the stage of
the disease. |
