Freiberg's Disease: A Suggested Pattern of Management

Helal, Basil; Gibb, Peter

doi:10.1177/107110078700800205

Cited by 74 publications

(49 citation statements)

References 8 publications

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“…[2][3][4][5][6][7][8][14][15][16][17][18][19][20][21][22][23][24] Excision of the metatarsal head is not recommended because of the risk of shortening of the toe, a break in the alignment of the metatarsal arch and transfer metatarsalgia, instability of the MTP joint and deformity of the toes, hallux valgus, and gait disturbance. 22,25 Joint replacement arthroplasty has been used in the advanced stages of the disease.…”

Section: Discussionmentioning

confidence: 99%

“…In the early stages of the disease (stages I, II, and III), it is possible to restore the joint congruity; joint debridement, elevation of the depressed articular fragment and bone graft, and metatarsal osteotomy can be considered. [5][6][7] On the other hand, it is difficult to restore the joint congruity in the later stages (stage IV or V), and the surgical options include joint arthroplasty, the Keller procedure, shortening metatarsal osteotomy, and osteochondral distal metatarsal allograft reconstruction. 3,7,8 Arthroscopic management of this disease has been reported.…”

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confidence: 99%

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Arthroscopic Interpositional Arthroplasty of the Second Metatarsophalangeal Joint

Lui¹

2016

Arthroscopy Techniques

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Painful degenerative diseases of the second metatarsophalangeal joint are frequently progressive and difficult to treat. Surgical options for the degenerated second metatarsophalangeal joint include joint debridement and synovectomy, drilling and microfracture, core decompression, dorsal closing-wedge metatarsal osteotomies, joint arthroplasty (implant or interpositional), elevation of the depressed articular fragment and bone graft, distraction arthroplasty, osteochondral plug transplantation, osteochondral distal metatarsal allograft reconstruction, and resection arthroplasty (phalangeal base or metatarsal head). This technical note describes the arthroscopic approach of interpositional arthroplasty of the second metatarsophalangeal joint using the extensor digitorum brevis tendon. It is indicated in adult patients with extensive involvement of the metatarsal head cartilage, especially when cartilage degeneration of the proximal phalanx is also present. It is contraindicated if there is significant bone loss of the metatarsal head or the extensor digitorum brevis tendon is flimsy.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Arthroscopic Interpositional Arthroplasty of the Second Metatarsophalangeal Joint

Lui¹

2016

Arthroscopy Techniques

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“…Üç hastada metatars başının genişlediğini, üç hastada da koşu ve yüksek topuklu ayakkabı ile ağrı oluştuğunu görmüşlerdir. [19] OSTEOTOMİ Birçok farklı osteotomi tanımlanmıştır. Amaç, hasarlı olan kıkırdak yüzeyin yükten kurtarılmasıdır.…”

Section: IVunclassified

“…Bası metatarsaljisi olan hastalarda osteotomiyi önerirlerken, eklem hareket açıklığı ve artritik değişikliklerden etkilenenlerde de artroplastiyi tercih etmişlerdir. [19] Erdil ve arkadaşları ise eklem debridmanı ile 14 ileri evre hastada iyi sonuç aldıklarını bildirmişlerdir. [20] KEMİK GREFTLEME Smillie orijinal makalesinde, çökmüş kıkırdağı kaldır-mak için metatars şaftına bir delik açarak sklerotik kemiğin delindiği, kıkırdağın kaldırılarak kemik grefti ile doldurulduğu bir yöntem tanımlamıştır.…”

Section: Eklem Debri̇dmaniunclassified

Çocukluk çağı ayak osteokondrozları

Akan¹

2017

TOTBID

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“…Surgical treatment is typically only performed when conservative therapy fails. Although various operative procedures, including resection arthroplasty, joint debridement, osteotomy, and osteochondral transplant, have been reported, no consensus regarding the best surgical approach has been reached to date [2][3][4][5][6][7][8][9][10][11][12]. Gauthier and Elbaz reported good results for dorsal intra-articular closingwedge osteotomy procedures regardless of the disease stage [4].…”

Section: Introductionmentioning

confidence: 99%

Extra-articular dorsal closing-wedge osteotomy to treat late-stage Freiberg disease using polyblend sutures: technical tips and clinical results

Ikoma

Maki

Kido

et al. 2014

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate the clinical outcomes regarding the dorsal wedge osteotomy fixed using a polyblend suture and describe the usefulness of this fixation method for the treatment of Freiberg disease. Methods The subjects consisted of 13 feet from 13 cases suffering from Freiberg disease that underwent extra-articular dorsal closing-wedge osteotomy using a polyblend suture. The average age was 31.7 (range 13-72) years. The average followup period was 17 (range 14-24) months. Regarding image findings, time to bone union and metatarsal shortening was reviewed. The investigation was carried out using the range of motion (ROM), visual analog scale (VAS), and Japanese Society of the Surgery of Foot lesser toe scale (JSSF score) in the MTP joint before surgery and at the latest follow-up. Results Calluses under the metatarsal head were not observed in any cases. The mean metatarsal shortening was 2.33± 2.07 mm at follow-up. The bone union required an average of 8.4±0.8 weeks. The average ROM of dorsal flexion improved from 37.2±5.3°before surgery to 73.6±9.9°at latest follow-up (p<0.0001). The average ROM of plantar flexion improved from 16.0±10.1°before surgery to 19.5±8.6°at latest follow-up (p=0.35). The average VAS significantly improved from 75.3±8.5 before surgery to 4.9±4.2 at latest follow-up (p<0.0001). The average JSSF score significantly improved from 67.3±9.4 points before surgery to 98.8±3.0 points at the latest follow-up (p<0.0001). Conclusion Extra-articular dorsal closing-wedge osteotomy using a polyblend suture was carried out to treat Freiberg disease. The bone union was observed in all cases with improved clinical results. Fixation using a polyblend suture was considered to be useful.

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Freiberg's Disease: A Suggested Pattern of Management

Cited by 74 publications

References 8 publications

Arthroscopic Interpositional Arthroplasty of the Second Metatarsophalangeal Joint

Arthroscopic Interpositional Arthroplasty of the Second Metatarsophalangeal Joint

Çocukluk çağı ayak osteokondrozları

Extra-articular dorsal closing-wedge osteotomy to treat late-stage Freiberg disease using polyblend sutures: technical tips and clinical results

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