Surgical treatment of advanced stage Freiberg disease

• Main Authors: Emin Özkul, Mehmet Gem, Celil Alemdar, Hüseyin Arslan, Ferit Boğatekin, Gökhan Meriç
• Format: Article
• Language: English
• Published: Dicle University Medical School 2014-09-01
• Series: Dicle Medical Journal
• Subjects: Freiberg disease; surgical treatment
• Online Access: http://www.diclemedj.org/upload/sayi/33/Dicle%20Med%20J-02129.pdf

Objective: Freiberg disesase is an avascular necrosis of the 2nd and 3rd metatarsal head and which kind of surgical option to be used is controversial in symptomatic patients. In this study the results of the advanced stage Freiberg’s disease patients, who were treated with surgery were evaluated. Methods: 12 patients (8 female, 4 male) whose pain could not be solved with conservative method and underwent surgery (6 debridement, 3 osteotomy, 3 excision of the metatarsal head) were included in this study. Themean age of the patients 19.1 (range 13- 31) and the mean follow-up 30.8(range 25-94) months. According to the Smillie classification 3 patients had type 5, 8 patients had type 4 and 1 patient had type 3 osteonecrosis. The results of the patients were evaluated according to Lesser Metatarsophalangeal-Interphalangeal Scale. Results: According to Lesser MetatarsophalangealInterphalangeal Scale 3 patients (%25) had excellent, 6 patients (%50) had good and 3 patients had poor results were obtained. 2 of 3 patients with poor results were type 5, and 1 patient was type 4 and all three patients underwent joint debridement. Conclusion:The method of surgical treatment of Freiberg disease determined according to the stage of the disease. Debridement alone in the treatment of patients with late stage is not enough, it should be combined with other methods.