Freiberg's disease and dorsiflexion osteotomy

A comperative study between two different surgical techniques in the treatment of late-stage Freiberg's disease

“…While some early stage lesions may resolve using these conventional procedures, patients who do not respond may require complex surgeries such as core decompression, dorsiflexion osteotomy, osteochondral plug transplantation and arthroplasties, as may patients with stage IV and stage V lesions [8][9][10][11][12][13][14][15][16][17]20]. Historically, the metatarsal head resection with/ without sindactilization was proposed, however, it has additional problems such as hallux valgus, transverse metatarsalgia, shortening of the toe.…”

“…A number of authors have reported information on the success of dorsal wedge osteotomies [7,8,10,11,13]. However, there are no long-term results to identify transfer metatarsalgia.…”

“…The first comprises procedures that alter the pathophysiology and abnormal biomechanics that may predispose an individual to the disease or worsen the clinical course. These include core decompression and corrective metatarsal osteotomy [8][9][10][11][12][13]. The second comprises procedures that restore articular congruity or address the degenerative features encountered in the later stages of the disease.…”

“…The second comprises procedures that restore articular congruity or address the degenerative features encountered in the later stages of the disease. These include debridement, osteotomy, grafting, and arthroplasty [8][9][10][11][12][13][14][15][16][17]. By reason of multi variety of treatment modalities, leads to uncertainties in predicting the choice of method and results when combining the low incidence of the disease.…”

Dorsiflexory Wedge Osteotomy to Treat Freiberg’s Infraction of the Second Metatarsal Head: A case report

“…This technique was later modified by Kinnard and Lirette who fixated the osteotomy with absorbable suture. 12 In 1999, Chao, Lee, and Lin published the extraarticular metaphyseal dorsal closing wedge osteotomy for treatment of Freiberg's infraction. Crossed Kirschner wires were utilized for fixation and were removed in all patients after radiographic signs of healing.…”