İleri evre Freiberg hastalığında eklem dışı dorsal kapama kama osteotomisi: klinik sonuçlar

Abstract

The aim of this study was to evaluate the results of dorsal close wedge osteotomy in addition to the debridement application on Freiberg disease in terms of functional recovery and pain relief. Material and Methods: Sixteen patients diagnosed with Freiberg disease (11 female,5 male) were included in the study and their articular surfaces were evaluated using direct roentgenogram and magnetic resonance imaging following the physical examination. The evaluation of the patients' articular surface was based on Smilie Classification. The cases were evaluated previous to surgery and in the 12th week of the postoperative period using visual analogue scale (VAS) to determine pain levels and using American Orthopaedic Foot and Ankle Society score (AOFAS) score to assess their functional recovery. Results: According to Smilie Classification, two cases were grade 2, six cases were grade 3, seven cases were grade 4 and one case was grade 5. The average dorsiflexion amount of the patients was 22 degrees (between 0 and 38) in preoperative period. It increased to 42 degrees on average (between 20 and 70) in the 12th week after the operation. The enlargement in arthroses and the swelling in metatarsophalangeal arthrosis due tosynovitis improved aesthetically in the 12th week after the operation. Conclusion: The application of dorsal close wedge osteotomy in addition to debridement in the case of Freiberg disease is effective in the adjustment of the articular surface, in maintaining metatarsal length, in increasing the articular's functionality.