[Treatment of symptomatic Freiberg's disease by resection arthroplasty]

Freiberg's disease is osteochondrosis or a vascular necrosis of metatarsal head. In many cases treatment is no operative. In patients who fail no operative treatment, surgical treatment may be offered. In this article, we studied surgical treatment with resection arthroplasty of metatarsophalyngeal joint in patients with unsuccessful no operative treatment. Resection arthroplasties of metatarsophalyngeal joint were performed in 16 patients with Freiberg's disease and unsuccessful no operative treatment between 2001 and 2007. In all patients, second metatarsophalyngeal joint involved. The average of follow up was 34 months [12-56]. There were 12 female [75%] and 4 male [25%] patients with an average age of 25 years [range 18-40]. There were excellent outcome in 12 [75%], good in 2 [12.5%] and moderate in 2 [12.5%] cases. Surgical treatment with metatarsophalyngeal joint resection arthroplasty has very good result in patients with Freiberg's disease that conservative treatments have failed

Relationship between anxiety, depression, and personality type and the incidence of reflex sympathetic dystrophy in patients with distal radius fracture

There is inconsistent information about the role of psychological factors in the incidence of reflex sympathetic dystrophy [RSD] in patients with distal radius fractures. The present study was thus undertaken to evaluate the relationship between some of these factors and the occurrence of reflex sympathetic dystrophy in patients with distal radius fracture. One hundred and twenty patients with distal radius fracture who met the criteria to enter the study and admitted to the orthopedic department of Imam Reza hospital in Mashhad were evaluated. Spielberger anxiety questionnaire, Beck depression questionnaire, and personality type questionnaires as well as the information about the patients' demography were recorded after the treatment. The patients were followed for two months based on clinical evidence of RSD and the results of specific examinations. In our study, Veldman's criteria were used to set the diagnosis of RSD. Finally, the psychological status of the patients with or without RSD was evaluated using Chi square and t tests. Of the 88 patients completed the study, 13 were affected by RSD. There was no significant relationship between depression and anxiety of the patients with occurrence of RSD [P > 0.05]. The presence of type A personality characters had a significant positive relationship [P = 0.000] and the presence of type B personality had a significant negative relationship [P = 0.004] with the incidence of RSD after 2 months. Personal characteristics of patients with distal radius fracture play a role in the incidence of RSD