Results of Dorsal Closing Wedge Osteotomy in Freiberg’s Disease

ABSTRACT

Introduction: Freiberg’s disease, the osteochondrosis of themetatarsal seen in our part of the world, usually at late stages,are refractory to the conservative treatment. Objective:Thepurpose of this study was to evaluate the results of dorsalclosing wedge osteotomy and pin fixation besides debridementand synovectomy.Material and Methods: Twenty patients (14 females,6 Males), mean age 19.3 years; range 14 to 26 years wereevaluated and teated by dorsal closing wedge osteotomy andpin fixation besides debridement and synovectomy, betweenseptember 2016 to 2018 at our institution. The presentingsymptoms were pain on walking or sports, limitation of dailyroutine activities, footwear problems, cosmetic deformitiesof forefoot and failed conservative treatment. Three patientshad a history of trauma. According to Smillies’s classificationtwelve patients were type IV and eight were Type V.Meanfollow-up period was 14.85 months(range 6 months to 24months).Results: Patients were assessed by the lessermetatarsophalangeal interphalangeal (LMPI) scale bykitaokaetal. At the final follow-up, scoring had changed from(44-66) with an average 54.65 to (76-100) with an average85.3. There was no case of infection, avascular necrosis,arthritis or pseudoarthrosis.Conclusion: Treatment of freiberg's disease with dorsalclosing-wedge osteotomy shows satisfactory pain relief andimprovement in quality of life