Results of Dorsal Closing Wedge Osteotomy in Freiberg’s Disease

Abstract

Introduction: Freiberg's disease, the osteochondrosis of the metatarsal seen in our part of the world, usually at late stages, are refractory to the conservative treatment. Objective:The purpose of this study was to evaluate the results of dorsal closing wedge osteotomy and pin fixation besides debridement and synovectomy. Material and Methods: Twenty patients (14 females, 6 Males), mean age 19.3 years; range 14 to 26 years were evaluated and teated by dorsal closing wedge osteotomy and pin fixation besides debridement and synovectomy, between september 2016 to 2018 at our institution. The presenting symptoms were pain on walking or sports, limitation of daily routine activities, footwear problems, cosmetic deformities of forefoot and failed conservative treatment. Three patients had a history of trauma. According to Smillies's classification twelve patients were type IV and eight were Type V.Mean follow-up period was 14.85 months(range 6 months to 24 months). Results: Patients were assessed by the lesser metatarsophalangeal interphalangeal (LMPI) scale by kitaokaetal. At the final follow-up, scoring had changed from (44-66) with an average 54.65 to (76-100) with an average 85.3. There was no case of infection, avascular necrosis, arthritis or pseudoarthrosis. Conclusion: Treatment of freiberg's disease with dorsal closing-wedge osteotomy shows satisfactory pain relief and improvement in quality of life.